基层医院新型抗肿瘤药物临床应用质量评价体系的构建及应用效果评价OA
Construction and Effect Evaluation of a Quality Evaluation System for Clinical Application of New Antineoplastic Drugs in Primary Hospitals
目的:构建新型抗肿瘤药物的临床质量评价体系,为提高基层医院合理用药提供保障.方法:结合权威指南、药品说明书及循证证据,采用德尔菲法筛选用药指征、选用品种、给药剂量、溶剂选择、输注浓度、给药顺序、预处理方案、联合用药 8 项核心评价指标,建立"智能审方+多学科团队+药学监护"全程药学干预体系.以某院使用新型抗肿瘤药物的住院患者为研究对象,选取干预前2021年1-12月567例患者为对照组,干预后2022年1-12月577例患者为干预组,比较两组新型抗肿瘤药物临床应用不合理率及各评价指标改善情况.结果:两组新型抗肿瘤药物应用不合理率分别为 26.28%、3.47%,其中干预组给药剂量、预处理方案、输注浓度、选用品种、用药指征、给药顺序的应用不合理率均较对照组下降,差异均有统计学意义(P<0.05);两组联合用药的应用不合理率对比,差异无统计学意义(P>0.05).结论:本研究构建的8项质量评价指标及三位一体的药学干预模式,可降低基层医院新型抗肿瘤药物不合理用药风险,规范临床用药流程,可为基层医疗机构抗肿瘤药物精细化管控提供可推广的实践方案.
OBJECTIVE:To construct a quality evaluation system for clinical application of new antineoplastic drugs,thus providing a guarantee for rational drug use in primary hospitals.METHODS:Referring to authoritative guidelines,drug package inserts and evidence-based basis,the Delphi method was adopted to screen 8 key indicators,including medication indication,selection of varieties,administration dosage,solvent selection,infusion concentration,administration sequence,pretreatment regimen,and combined medication,to establish a whole-process pharmaceutical intervention system of"intelligent prescription review+multi-disciplinary team+pharmaceutical care".Taking inpatients receiving new antineoplastic drugs in a primary hospital as the research subjects,567 patients from January to December 2021 before the intervention were selected as the control group,and 577 patients from January to December 2022 after the intervention were selected as the intervention group.The unreasonable rate of clinical application of new antineoplastic drugs and the improvement of each evaluation indicator were compared between the two groups.RESULTS:The unreasonable application rates of new antineoplastic drugs in 2 groups were 26.28%and 3.47%respectively.The unreasonable rates of administration dosage,pretreatment regimen,infusion concentration,selection of varieties,medication indication and administration sequence in the intervention group were all lower than those in the control group,and the differences were statistically significant(P<0.05);there was no statistically significant difference in the unreasonable rate of combined medication between the two groups(P>0.05).CONCLUSIONS:The 8 quality evaluation indicators and the trinity pharmaceutical intervention model constructed in this study can reduce the risk of irrational use of new antineoplastic drugs in primary hospitals,standardize the clinical medication process,and can be used as a promotable practical scheme for the refined management of antineoplastic drugs in primary hospitals.
王超花;刘婷婷;郭瑞臣
东阿县人民医院/聊城市心脏病医院药学部,山东 聊城 252200东阿县人民医院/聊城市心脏病医院药学部,山东 聊城 252200山东大学齐鲁医院临床药理研究所,济南 250000
医药卫生
新型抗肿瘤药物德尔菲法质量评价体系药学干预措施
New antineoplastic drugsDelphi methodQuality evaluation systemPharmaceutical intervention
《中国医院用药评价与分析》 2026 (9)
1029-1031,1039,4
山东省医学会临床科研资金-齐鲁专项(No.YXH2022ZX02077)
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