| 冯晓俊,邓明影,李宇,等.华法林药物利用评价标准的构建及运用研究[J].安徽医药,2018,22(11):2257-2261. |
| 华法林药物利用评价标准的构建及运用研究 |
| Establishment and application of drug use evaluation standard of warfarin |
| 投稿时间：2017-02-15 |
| DOI： |
| 中文关键词: 华法林 药物利用评价 标准 专家咨询法 |
| 英文关键词: Warfarin Drug use evaluation Standard Expert consultation |
| 基金项目: |
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| 中文摘要: |
| 目的 建立华法林药物利用评价(DUE)标准,用于评价华法林临床使用的合理性,为临床合理使用华法林提供参考。方法 参考华法林药品说明书、国内外华法林临床应用指南及专家共识,并按照DUE标准基本框架的构建原则,构建华法林DUE标准基本框架,结合专家咨询法,对标准进行修订完善,建立华法林DUE标准。设计调查表,按照排除和纳入标准收集使用的华法林病例资料,评估华法林使用情况。结果 建立的华法林评价标准主要包括用药指征、用药过程、用药结果、不良反应及处理等4个方面及11个二级指标。应用结果显示某三甲医院使用华法林适应证选择基本合理,住院患者华法林给药频次较合理,为每天一次给药(用法、用量符合标准),未出现配伍禁忌。用药不合理主要表现为用药过程中患者的初始剂量的选择较少个体化给药(基因型检测占比仅为6.67%),服用华法林2～3d后检测国际标准化比值(INR)的患者比例为41.67%,以及INR值基本达到目标范围(2～3d)比例36.67%。结论 建立的华法林DUE标准,在实践中可用于发现临床用药过程中存在的问题和不足,具有很强的实用性,可为华法林的临床应用提供有益参考。 |
| 英文摘要: |
| Objective To establish the drug use evaluation (DUE) of warfarin to evaluate the rationality of the clinical use of warfarin and provide a reference for the rationally clinical use of warfarin.Methods We constructed the basic framework of DUE standard for warfarin by consulting warfarin dispensatory,domestic and overseas clinical application guidelines of warfarin and expert consensus.Then,combined with expert consultation results,we revised the standard,and established the DUE standard of warfarin.Questionnaires were designed and warfarin case data were collected according to the exclusion and inclusion criterion and the use of warfarin was assessed.Results The established warfarin evaluation criteria mainly included four categories and 11 secondary indicators,which covered drug indication,medication process,drug use results,and adverse reactions and treatment.The application results showed that the choice of warfarin in a tertiary hospital was basically reasonable.The frequency of administration of warfarin in hospitalized patients was reasonably once a day (usage and dosage met the standard),and no incompatibility was observed.The irrational use was mainly characterized by the fact that the initial dose of the patient was seldom individualized (genotype detection accounted for only 6.67%),and the proportion of patients who had the international normalized ratio (INR) value detected after 2 to 3 days of taking warfarin was 41.67%,and the INR being in the target range (2 to 3 days) was 36.67%.Conclusion The established DUE standard of warfarin can be used to find the problems and shortcomings during clinical treatment,which has a strong practicability and can be a useful reference for the clinical application of warfarin. |
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