| 摘要: |
| 目的：回顾性分析2017年西北妇女儿童医院儿科门诊超说明书用药现状，分析超说明书用药危险因素，为规范儿科临床用药提供数据支持。方法：随机抽取我院2017年儿科门诊处方，以药品说明书为依据，分析用药医嘱是否超说明书用药，并整理归纳我院超说明书用药的种类、不同年龄段儿童发生超说明书用药的情况、不同种类药物超说明书用药发生率。同时，分析超说明书用药与患儿基本信息（年龄、性别）和药品信息（基本药物、OTC分类）的相关性。结果：共纳入2 640张儿科门诊处方，涉及用药医嘱4 435条，其中药物品规155种。按处方、用药医嘱和药品种类分类，超说明书用药发生率依次为35.55%、46.76%、91.61%。超说明书用药在以下3种临床用药中较为常见：（1）使用说明书未涉及儿童用药信息（34.28%），（2）给药频次不合理（28.45%）)，（3）剂量超标（16.42%）。超说明书用药居前2位的年龄段分别为青少年（50.00%）和婴幼儿（47.64%）。超说明书用药居前3位药物种类分别为呼吸系统药物（33.50%）、中成药( 18.74%)、全身用抗感染药物（17.95%）。全院门诊各年龄段患儿超说明书用药风险差异无统计学意义。患儿性别方面存在超说明书用药风险差异无统计学意义。非基本药物和OTC存在较高的超说明书用药风险。结论：2017年我院儿科门诊超说明书用药发生较为普遍，需进一步宣教临床医师合理使用儿童药物，规避患儿用药风险。 |
| 关键词: 超说明书用药 儿科 门诊 危险因素分析 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2020.03.010 |
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| 基金项目:陕西省卫生计生科研基金项目,编号2016D056。 |
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| Investigation of Off-Label Drug Use in Pediatric Outpatient Department of Our Hospital in 2017 |
| Shen Yixuan, Liu Zhenguo, Li Siwei, Chang Ying |
| (Northwest Women and Children’s Hospital, Shaanxi Xi’an 710061, China) |
| Abstract: |
| Objective: To retrospectively analyze the application status of off-label drug use in pediatric outpatient department of Northwest Women and Children’s Hospital in 2017, and to analyze the risk factors of off-label drug use, so as to provide data support for standardizing clinical medication in pediatrics. Methods: Prescriptions of pediatric outpatient department in our hospital in 2017 were randomly selected. According to drug instructions, off-label drug use of prescriptions of all selected children were analyzed, including the category of off-label drug use, off-label drug use in children of different ages and incidence of off-label drug use with different category of drugs. Meanwhile, the correlation between off-label drug use and basic information (age, gender) and drug information (essential drugs, OTC classification) was analyzed. Results: A total of 2,640 outpatient pediatric prescriptions with 4,435 medical orders were extracted, including 155 kinds of drugs. According to prescriptions, medication orders and drug categories, the incidence of off-label drug use were 35.55%, 46.76% and 91.61%, respectively. Off-label drug use were more common in the following three clinical medications: (1) no pediatric information (34.28%), (2) irrational frequency of administration (28.45%), (3) over dose (16.42%). The age group with the highest incidence of off-label drug was adolescents (50.00%) and infants (47.64%). The top three drug categories ranked by off-label drug use were respectively respiratory system drugs (33.50%), traditional Chinese patent medicine (18.74%) and systemic anti-infectives (17.95%). There is no statistically significant difference in the risk of off-label drug use for children of all ages in the outpatient department of our hospital. And there is no statistically significant difference in the risk of off-label drug use in children’s gender. Non-essential drugs and OTC had a higher risk of off-label use. Conclusion: Off-label drug use in pediatric outpatient department of our hospital in 2017 is relatively common. It is necessary to further standardize the use of drugs by clinicians and promote the rational use of drugs, so as to avoid medication risks in children |
| Key words: off-label drug use pediatrics outpatient department risk factors analysis |
