| 摘要: |
| [摘要]目的：调查儿童重症患者超说明书用药现状，分析可能的超说明书用药危险因素，为促进儿科重症监护病区合理用药提供参考。方法：分层随机抽取西北妇女儿童医院2019年儿科重症监护病区的医嘱，根据药品说明书，判断是否超说明书用药。分析不同年龄段、不同科室、不同级别医师、不同种类药品的超说明书用药发生率。分析超说明书用药与患儿基本信息（年龄、性别）、医师级别和药品信息（基本药物、高警示药物）的相关性。结果：共纳入患儿864例，医嘱13 926条，药品200种，超说明书用药发生率分别为87.27%、53.02%和56.00%。新生儿、女性患儿、高职称医师、基本药物、高警示药物存在较高的超说明书用药风险（P<0.05）。结论：儿童重症患者超说明书用药情况普遍存在，新生儿、女性患儿、高职称医师、基本药物、高警示药物为超说明用药的危险因素。药师需发挥用药指导作用，协助医师规避用药风险，促进重症患儿安全合理用药。 |
| 关键词: 儿科 重症监护病区 超说明书用药 危险因素分析 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2021.10.009 |
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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 Intensive Care Unit |
| Zhao Kai1, Tian Zhen2, Zhao Fang1, Shen Yixuan1, Li Siwei1, Chang Ying1 |
| (1. Northwest Women’s and Children’s Hospital, Shaanxi Xi’an 710061, China; 2. Guangzhou Women and Children’s Medical Center, Guangdong Guangzhou 510623, China) |
| Abstract: |
| [Abstract] Objective: To investigate the application status of off-label drug use in children from pediatric intensive care unit (PICU), and to analyze the risk factors of off-label drug use, so as to provide reference for promoting the rational drug use in PICU. Methods: Medical orders were selected from the PICU of Northwest Women’s and Children’s Hospital in 2019 through the proportionate stratified random sampling method, and off-label drug use was judged according to the drug instructions. The incidences of off-label drug use in different age groups, departments, levels of clinicians and different kinds of drugs were analyzed. Correlation between off-label drug use and children’s basic information (age, gender), levels of clinicians and drug information (essential drugs, high-alert drugs) was analyzed. Results: A total of 864 children were enrolled, including 13,926 medical orders and 200 kinds of drugs. The incidence of off-label drug use was respectively 87.27%, 53.02% and 56.00%. Newborns, female children, clinicians with high professional titles, essential drugs and high-alert drugs had higher risks of off-label drug use (P<0.05). Conclusion: Off-label drug use is widespread in children from PICU. Newborns, female children, clinicians with high professional titles, essential drugs and high-alert drugs are risk factors of off-label drug use. Pharmacists are supposed to play a role in guiding rational drug use, assisting clinicians in avoiding drug use risks and promoting the safe and rational drug use in critically ill children. |
| Key words: pediatrics intensive care unit off-label drug use risk factors analysis |
