CAJ | 학술논문

目的调查上海市社区医院平喘药物使用情况,了解社区医院在哮喘和慢性阻塞性肺病诊治指南执行中存在的问题,并探讨原因.方法收集上海市某区5家社区医院2013年度平喘药物的使用量.以药物限定日剂量(DDD值)为依据对用药量进行换算,计算出药物的用药频度(DDDs)及不同类别药物构成比.并与同区的1家二级和1家三级医院的数据进行比较.结果 3个级别医院口服平喘药使用比例差异不明显,社区、二级、三级医院分别为20％、20％和22％.但口服药物的品种在二、三级医院以白三烯受体拮抗剂为主(56％和73％),社区医院全部为口服茶碱类和β2受体激动剂.在吸入平喘药物中,二、三级医院以糖皮质激素为主(50％和68％),社区医院全部为短效β2受体激动剂.吸入装置中,二、三级医院以干粉吸人剂为主(64％和83％),一级医院全部为定量压力气雾剂.结论上海市社区医院平喘药物的使用与指南要求有较大距离.需要从完善医院药品配置、加强医务人员继续教育、改变患者用药观念和提高国内药企生产雾化剂积极性等方面提高.
목적 조사상해시사구의원평천약물사용정황,료해사구의원재효천화만성조새성폐병진치지남집행중존재적문제,병탐토원인.방법 수집상해시모구5가사구의원2013년도평천약물적사용량.이약물한정일제량(DDD치)위의거대용약량진행환산,계산출약물적용약빈도(DDDs)급불동유별약물구성비.병여동구적1가이급화1가삼급의원적수거진행비교.결과 3개급별의원구복평천약사용비례차이불명현,사구、이급、삼급의원분별위20％、20％화22％.단구복약물적품충재이、삼급의원이백삼희수체길항제위주(56％화73％),사구의원전부위구복다감류화β2수체격동제.재흡입평천약물중,이、삼급의원이당피질격소위주(50％화68％),사구의원전부위단효β2수체격동제.흡입장치중,이、삼급의원이간분흡인제위주(64％화83％),일급의원전부위정량압력기무제.결론 상해시사구의원평천약물적사용여지남요구유교대거리.수요종완선의원약품배치、가강의무인원계속교육、개변환자용약관념화제고국내약기생산무화제적겁성등방면제고.
Objective To observe the usage of antiasthmatic drugs and seek problems of following the guidelines of asthma and COPD prevention & treatment in community hospitals.Methods The prescribed quantity in 2013 of antiasthmatic drugs was recorded for 5 community hospitals in a district of Shanghai.Basing on the defined daily dose (DDD),the dosing frequency of drugs (DDDs) and the percentages of each category of drugs were calculated.Then comparisons were made with the data of a grade Ⅱ hospital and a grade Ⅲ hospital in the same district.Results Among three level hospitals,no significant difference existed in the percentages of oral antiasthmatic drugs.But the major category of oral drugs at grades Ⅱ-Ⅲ hospitals was leukotriene receptor antagonist whereas only oral theophylline and oral β2-receptor agonists were available at community hospitals.Among inhaled drugs,inhaled corticosteroids (ICS) dominated at grades Ⅱ-Ⅲ hospitals.But at community hospitals,inhaled short-acting beta-agonists (SABA) predominated.Among inhalants,dry powder inhaler (DPI) dominated at grades Ⅱ-Ⅲ hospitals and metered dose inhaler (MDI) at community hospitals.Conclusions The usage of antiasthmatics at community hospitals is not consistent with the guidelines.Optimizing drug purchasing at hospitals,strengthening continued medical education,modifying the medication concept of patients and boosting the production of domestic inhalants should be urgently undertaken.