目的:通过运用改良Jadad量表法筛选高质量的文献,以此作为医院超说明书用药的循证依据,为评价合理用药建立标准提供一种方式.方法:随机抽取使用硫辛酸注射液的医嘱360份进行处方点评分析,判断其与说明书的符合程度.同时运用改良Jadad量表对检索的文献进行评分,评分大于4分的文献作为超说明书使用的循证依据,以此为依据对临床的硫辛酸注射液使用进行分析,并收集患者转归情况进行统计.结果:超适应症用药医嘱357例,无文献依据的应用2例.超适应症用药的医嘱中临床诊断主要集中在心脏术后,肿瘤、肝脏损伤等相关疾病,患者最终的转归情况良好,治愈244例(67.78％),好转102例(28.33％).结论:采用改良Jadad量表法筛选高质量文献作为评价超说明书用药是否合理的标准,为超说明书用药提供循证依据的一种新的尝试.%Objective:High quality literatures were selected by the modified Jadad scale method as ev idence base of hospital's off-label drug use to provide a way for evaluating the standard of off-label drug use in hospitals.Methods:A total of 360 prescriptions with lipoic acid injections were randomly selected to determine the degree of compliance with the specification.At the same time,the modified Jadad scale was used to choose literature scored over 4 points as evidence base of off-label use,and the patients were followed up.Results:There were 357 cases of drug use off-label,and 2 cases off-literature.Off-label prescriptions were mainly for cardiac surgery or diseases related to tumor or liver injury,patients′ final outcome were good with 244 cured (67.78％) and 102 improved (28.33％).Conclusion:In our hospital,the use of modified Jadad scale method to select high quality literature as a evaluation standard is a new attempt to provide evidence base for the drug clinical off-label use.
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