Analysis on the application of oral anticoagulants in respiratory diseases in six cities in China from 2013 to 2017_West China Medical Journal

Authors：

ZHANG Jingyi ,  XU Ting , QIN Zhou , WU Bin , YAN Yu

Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

XU Ting, Email: tingx2009@163.com

Keywords：

Oral anticoagulant; Drug consumption sum; Number of prescription; Prescribed daily dose; Defined daily dose

DOI：

10.7507/1002-0179.201812077

Video：

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Objective To realize the application status and development trend of oral anticoagulant drugs used in respiratory diseases in 72 hospitals in 6 cities from the year 2013 to 2017.Methods From January 2013 to December 2017, we randomly selected the electronic information from 10 working days per quarter in 6 cities including Beijing, Guangzhou, Shanghai, Chengdu, Shenyang, and Zhengzhou, with 12 hospitals in each city, and summarized the information into the prescription database of the hospital prescription analysis project. Through the hospital information system, we screened out the information of outpatient prescriptions and inpatient medical records which used oral anticoagulants. The prescriptions with respiratory diseases related-diagnosis were selected as the research objects by manual screening. The application of oral anticoagulant drugs used in respiratory diseases was statistically analyzed by drug amount, prescription amount, prescribed daily dose (PDD), and defined daily dose (DDD).Results From 2013 to 2017, the number of warfarin sodium prescriptions was successively 4 769, 5 747, 7 549, 7 261, and 7 151, which had been always ranked the first in the five years, but decreased year by year since 2015. The proportion of warfarin sodium drug use amount decreased year by year from 32.52% in 2013 to 5.03% in 2017. The proportion of prescription and drug consumption sum of new oral anticoagulants increased year by year in the past five years. The PDD/DDD of warfarin sodium, dabigatran etexilate, rivaroxaban, and apixaban were 0.41, 0.73, 0.68, and 0.33, respectively. There were off lable use of new oral anticoagulants.Conclusions Warfarin still dominates the proportion of oral anticoagulants prescribed in the 72 hospitals in the 6 cities in the five years. The clinicians have made a comprehensive judgment after fully considering the safety, effectiveness, and economy of drug use when formulating drug treatment programs.

Citation： ZHANG Jingyi, XU Ting, QIN Zhou, WU Bin, YAN Yu. Analysis on the application of oral anticoagulants in respiratory diseases in six cities in China from 2013 to 2017. West China Medical Journal, 2019, 34(1): 22-29. doi: 10.7507/1002-0179.201812077 Copy

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1. 董军, 刘寅. 抗凝药物的进展及临床应用. 中华老年心脑血管病杂志, 2013, 15(12): 1333-1335.
2. 黄海彬, 卢晓霞, 邱倩倩, 等. 抗凝药物临床应用的研究进展. 海峡药学, 2013, 25(6): 1-4.
3. 任小婵, 罗选娟, 杨欢, 等. 新型口服抗凝药的临床应用研究进展. 中华全科医学, 2018, 16(4): 615-619, 666.
4. World Health Organization. Introduction to drug utilization research 2003. Oslo, Norway: 2003. http://apps.who.Int/medicinedocs/en/d/Js4876e/7.html.
5. 陈新谦, 金有豫, 汤光. 新编药物学. 17 版. 北京: 人民卫生出版社, 2011: 536-537.
6. 罗文苹. 新型口服抗凝药在治疗血栓栓塞性疾病中的研究进展. 重庆: 重庆医科大学, 2015.
7. 杜昕, 郭伟. 新型口服抗凝药是否可以取代华法林用于静脉血栓栓塞症抗凝治疗. 中国血管外科杂志: 电子版, 2016, 8(3): 178-182.
8. 中华医学会心血管病学分会, 中国老年学学会心脑血管病专业委员会. 华法林抗凝治疗的中国专家共识. 中华内科杂志, 2013, 52(1): 76-82.
9. 何培根, 闵新文, 郑芳, 等. 华法林钠药理作用影响因素与华法林钠用药监护. 医药导报, 2011(5): 668-671.
10. Rieder MJ, Reiner AP, Gage BF, et al. Effect of VKORC1 haplotypes on transcriptional regulation and warfarin dose. N Engl J Med, 2005, 352(22): 2285-2293.
11. 徐建华, 邹颖. 胺碘酮可增强华法林的抗凝作用分析. 南通大学学报: 医学版, 2012, 32(3): 243-244.
12. 张先龙. 新型口服抗凝药物阿哌沙班. 中华关节外科杂志: 电子版, 2014(4): 543-546.
13. Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest, 2016, 149(2): 315-352.
14. 中国健康促进基金会血栓与血管专项基金专家委员会, 中华医学会呼吸病学分会肺栓塞与肺血管病学组, 中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会. 医院内静脉血栓栓塞症防治与管理建议. 中华医学杂志, 2018, 98(18): 1383-1388.
15. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace, 2016, 18(11): 1609-1678.
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20. 覃涛, 樊荣, 何纪毅. 超说明书用药合法吗?. 中国医院院长, 2018(19): 84-87.

West China Medical Journal

Analysis on the application of oral anticoagulants in respiratory diseases in six cities in China from 2013 to 2017

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