综合干预管理模式对我院肿瘤科PPIs注射剂使用的干预效果评价
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篇名: 综合干预管理模式对我院肿瘤科PPIs注射剂使用的干预效果评价
TITLE:
摘要: 目的:评价综合干预管理模式对医院肿瘤科质子泵抑制剂(PPIs)注射剂使用的干预效果。方法:采用单纯随机抽样方法,抽取我院肿瘤科使用PPIs注射剂的出院病历,2012年1月-2013年12月(干预前)1 457份、2014年1-12月(干预后)793份,比较行政干预、技术干预及信息化管理等措施综合干预前后PPIs注射剂的使用情况。结果:经综合干预后,PPIs注射剂的使用率由干预前的62.59%下降至60.70%,差异无统计学意义(P>0.05)。干预前后PPIs注射剂的消耗金额在总医疗费用中的占比及人均消耗金额比较,差异均有统计学意义(P<0.05)。注射用兰索拉唑的使用率由干预前的19.70%上升至34.68%,注射用奥美拉唑的使用率由干预前的34.45%下降至25.60%,差异均有统计学意义(P<0.05);而干预前后注射用泮托拉唑及注射用埃索美拉唑的使用率比较,差异均无统计学意义(P>0.05)。PPIs注射剂不合理使用的比例由干预前的73.99%下降至55.86%,其中无适应证用药、重复用药及疗程过长的比例分别由干预前的40.01%、17.09%和26.90%下降至32.41%、9.08%和18.03%,差异均有统计学意义(P<0.05);而干预前后剂量选择不当的比例比较,差异无统计学意义(P>0.05)。结论:综合干预管理模式可一定程度地改善PPIs注射剂的临床使用情况,但PPIs注射剂不合理使用的现象仍不容乐观,有待完善干预措施,进一步持续干预,促进其临床合理应用。
ABSTRACT: OBJECTIVE: To evaluate the effect of comprehensive intervention management mode on the use of proton pump inhibitors (PPIs) injection in oncology department of hospital. METHODS: Simple random sampling method was conducted to collect 1 457 discharged medical records used PPIs injection in oncology department of our hospital from Jan. 2012 to Dec. 2013 (before intervention) and 793 records from Jan. to Dec. 2014 (after intervention). The utilization of PPIs injection before and after administrative intervention, technical intervention and information management was compared. RESULTS: After comprehensive intervention, the utilization rate of PPIs injection in oncology department of our hospital decreased from 62.59% (before intervention) to 60.70%, without significant difference (P>0.05). There were significant differences in the proportion of PPIs injection’s consumption amount in total medical costs and per capita consumption amount before and after intervention (P<0.05); the utilization rate of Lansoprazole for injection increased from 19.70% (before intervention) to 34.68%, and the Omeprazole for injection decreased from 34.45% (before intervention) to 25.60%, with significant differences (P<0.05), while there were no significant differences in the utilization rate of Pantoprazole for injection and Esomeprazole for injection (P>0.05). The proportion of irrational use of PPIs injection decreased from 73.99% (before intervention) to 55.86%, among which, the proportions of no indications of medication, repeated administration and too long duration decreased from 40.01%, 17.09% and 26.90% (before intervention) to 32.41%, 9.08% and 18.03%, with significant differences (P<0.05), while there was no significant difference in the proportion of inappropriate dose selection before and after intervention (P>0.05). CONCLUSIONS: Comprehensive intervention management mode can improve the clinical utilization of PPIs injection in oncology department of our hospital to some extent, but the irrational use of PPIs injection in our hospital is still not optimistic, which needs further improve intervention to promote its clinical rational use.
期刊: 2016年第27卷第23期
作者: 许建国,朱华,吴茗菁
AUTHORS: XU Jianguo,ZHU Hua,WU Mingjing
关键字: 质子泵抑制剂;合理用药;综合干预;效果;评价
KEYWORDS: Proton pump inhibitor; Rational drug use; Comprehensive intervention; Effect; Evaluation
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