今日药学

2016, v.26(08) 574-577

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某院风湿科住院患者免疫抑制剂超说明书用药情况分析
Analysis on Off-Label Use of Immunosuppressant in Department of Rheumatology of A Hospital

徐丹;冯霞;陈丽金;钟询龙;叶丽卡;王若伦;
XU Dan;FENG Xia;CHEN Lijin;ZHONG Xunlong;YE Lika;WANG Ruolun;The Second Affiliated Hospital of Guangzhou Medical University;

摘要(Abstract):

目的通过对本院风湿科住院患者免疫抑制剂使用情况进行调查,对超说明书用药进行分析,为规范超说明书用药行为提供有益的参考。方法随机抽取2015年在本院风湿科住院的病历240份,根据免疫抑制剂药品说明书内容,判断其是否为超说明书用药,参考国内外指南、文献等对超说明书用药进行合理性评价。结果超说明书用药发生率为26.3%,均为超适应证用药,占据超说明书用药医嘱条数前3位依次是甲氨蝶呤片/注射液(26.8%)、吗替麦考酚酯胶囊/片(16.1%)和硫酸羟氯喹片(12.8%)。结论免疫抑制剂超说明书用药在风湿科较常见,患者有用药指征,所调查医嘱有国内诊疗指南及文献支持,较为合理。
OBJECTIVE To analyze the off-label use of immunosuppressant in the department of rheumatology of the hospital,so as to provide beneficial references for standardizing the off-label use. METHODS A total of 240 medical records of the in-patients in the department of rheumatology in 2015 were selected randomly,and then judged whether they belonged to off-label use or not according to the insert of the immunosuppressant,and then reasonable assessment was made for off-label use with reference to the domestic and foreign guidelines,literatures and so on. RESULTS The incidence rate of the off-label use was 26.3%,which were used beyond the indications,and the top 3 numbers of off-label use medical orders were methotrexate tablet / injection( 26.8%),mycophenolate mofetil capsule / tablet( 16.1%) and hydroxychloroquine sulfate tablet( 12. 8%),respectively. CONCLUSION The off-label use of the immunosuppressant is relatively frequent in the department of rheumatology,and the dosing indications and medical orders for patients were supported by domestic diagnosis guidelines and literatures and were relatively reasonable.

关键词(KeyWords): 风湿科;免疫抑制剂;超说明书用药
rheumatology;immunosuppressant;off-label use

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基金项目(Foundation): 广东省临床用药研究基金(2015FS14)

作者(Author): 徐丹;冯霞;陈丽金;钟询龙;叶丽卡;王若伦;
XU Dan;FENG Xia;CHEN Lijin;ZHONG Xunlong;YE Lika;WANG Ruolun;The Second Affiliated Hospital of Guangzhou Medical University;

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