靜脈用抗腫瘤藥不合理應用及干預方式分析

郭霞

【摘要】 目的 分析靜脈用抗腫瘤藥不合理應用及干預方式。方法 抽取13285張靜脈用抗腫瘤藥方， 根據藥品說明書、工具書、參考文獻等資料對其中的不合理用藥醫囑進行分類， 然后分析不合理用藥占比和更正醫囑占比。分析藥師干預前后的變化， 并統計靜脈用抗腫瘤藥不合理醫囑數量和不合理用藥類型。結果 ①統計2016～2018年靜脈用抗腫瘤藥不合理醫囑數量， 共13285張靜脈用抗腫瘤藥物的醫囑， 其中不合理用藥的醫囑共265張、占1.99%， 更正醫囑共204張、占76.98%。②統計2016～2018年靜脈用抗腫瘤藥不合理用藥類型， 主要包括溶劑選用不當、溶劑用量不當、給藥頻次不當、給藥途徑錯誤、配伍禁忌、給藥順序不當、執行醫囑錯誤， 其中占比最高的類型為溶劑選用不當（39.62%）， 最低的類型為執行醫囑錯誤（1.13%）。結論 靜脈藥物配置中心對抗腫瘤藥物的使用進行規范干預， 可以有效地提高抗腫瘤藥物的合理使用率和安全程度， 從而減少抗腫瘤藥物不合理使用事件和用藥成本。

【關鍵詞】 抗腫瘤藥;不合理用藥;干預方式;靜脈藥物配置中心;藥師

DOI：10.14163/j.cnki.11-5547/r.2019.18.066

Analysis of unreasonable application and intervention of intravenous antineoplastic drugs? ?GUO Xia. East District Pharmacy Intravenous Admixture Services， Suzhou Municipal Hospital， Suzhou 215000， China

【Abstract】 Objective? ?To analyze the unreasonable application and intervention of intravenous anti-tumor drugs. Methods? ?13285 intravenous antineoplastic prescription were selected and classified according to drug instructions， reference books and other materials. Then the proportion of irrational drugs and corrected orders were analyzed. The changes before and after intervention of pharmacists was analyzed， and the number of irrational orders and types of irrational use of intravenous antineoplastic drugs was counted. Results? ?①The number of unreasonable medical orders for intravenous antineoplastic drugs in 2016 ～ 2018 was counted. There were 13285 medical orders for intravenous antineoplastic drugs， including 265 unreasonable orders， accounting for 1.99%， and 204 corrected orders， accounting for 76.98%. ②The types of irrational use of intravenous antineoplastic drugs in 2016～2018 were analyzed， including improper selection of solvents， improper dosage of solvents， improper frequency of administration， wrong route of administration， incompatibility， improper order of administration and wrong execution of doctors orders. Among them， improper selection of solvents accounted for the highest proportion （39.62%） and wrong execution of doctors orders accounted for the lowest proportion （1.13%）. Conclusion? ?Regular intervention of pharmacy intravenous admixture services in the use of antineoplastic drugs can effectively improve the rational use rate and safety of antineoplastic drugs， thereby reducing irrational use events and drug cost of antineoplastic drugs.

【Key words】 Antineoplastic drugs; Unreasonable drug use; Intervention mode; Pharmacy intravenous admixture services; Pharmacist