Objective To analyze the rationality of emergency medication in the West China Hospital after Lushan earthquake based on the actual drug use of earthquake victims. Methods We applied DDDs and DUI as evaluation index, input data using Excel software, and analyzed if the emergency medication was required for the injury/illness and the rationality of emergency medication. Results Earthquake victims mainly had trauma and wound infection and they were given antibiotics as main treatment one week after the earthquake. Drugs for the respiratory system and digestive system were mainly used in patients who mainly manifested as non-traumatic diseases and internal diseases four weeks after the earthquake. Among 49 kinds of drugs which could be calculated for the value of DUI, injection accounted for a larger proportion than non-injection (59.18% vs. 40.82%). The results showed that, the medication (DUI=1) only accounted for 12.24%; the medication (DUIlt;1, Mean=0.65) accounted for 38.78%, which implied insufficient drug use; the medication (DUIgt;1, Mean=1.77) accounted for 46.94%, which implied drug overuse. Conclusion Medication for every system is basically timely and rational when treating symptoms and causes in the West China Hospital within one month after Lushan earthquake. However, the rationality of emergency medications using DUI=1 under normal conditions still needs to be further verified.
Objective To investigate drug usage and costs of chronic obstructive pulmonary disease (COPD) inpatients in Karamay Central Hospital in 2014 and to provide evidence and reference for evidence-based pharmacy study on COPD. Methods The information of drug use and expenditure of COPD inpatients were collected from the hospital information system (HIS). We analyzed the data including frequency, proportion and cumulative proportion by Excel 2007 software. Results A total of 194 inpatients with COPD/AECOPD were included in Karamay Central Hospital in 2014, the average age was 74.28±7.81 years old. Fifty-three drugs were used for COPD treatment; the total frequency were 1 798 times and per capita cost was 7 419.78 yuan. The top three used drugs were budesonide suspension, montelukast tablets and methylprednisolone injection. In total expenditure, the cost of piperacillin-tazobactam, imipenem/cilastatin and moxifloxacin injection ranked top three. Conclusion The top 3 used drugs are budesonide suspension, montelukast tablets and methylprednisolone injection for COPD inpatients in Karamay Central Hospital in 2014, while the top 3 total expenditure drugs are piperacillin-tazobactam, imipenem/cilastatin and moxifloxacin injection.
Objective To evaluate the rationality of drug treatment for cardiovascular diseases in aged people and the effects of evidence-based practice. Methods Descriptive study was conducted to compare the therapies for the patients suffering from cardiovascular diseases before and after evidence-based practice by investigating drug use during 1998-1999 (211 cases) and 2002-2003 (211 cases). Results Among antihypertensive drugs, the ACEIs and diuretics played a more important role than before. CCBs and ACEIs were still the most frequently used drugs, and drug combination was more common, comparing to that before evidence-based practice. Lipid lowering drugs and ACEIs were used more common in coronary heart disease. Quality of life of patients was more emphasized and combination use of anti-anxiety drugs was adopted. When treating heart failure, β-receptor blockers, aldadinc and ACEIs were more frequently used. Conclusions After evidence-based practice, drug use is much more based on evidence instead of experience and textbook. As a result, the rate of reaching ideal blood pressure is higher than before. The rate of rational drug use before and after evidence-based practice has increased from 42% to 78%, respectively.
Objective To investigate drug usage and costs of pneumonia inpatients in Karamay Central Hospital in 2014 and to provide baseline for evidence-based pharmacy study of single disease in respiratory system. Methods The information of drug use and expenditure of pneumonia inpatients were collected from the hospital information system (HIS). We analyzed the data including frequency, proportion and cumulative proportion by Excel 2007 software. Results A total of 309 inpatients were included, among the 78.96% were more than 60 years old. Among the antibiotics single therapy, the frequency of cefoperazone and sulbactam was the highest. Among the antibiotics combination therapy, the frequency of β-lactam antibiotics was the highest. Conclusion Pneumonia inpatients in Karamay Central Hospital are mainly older patients. The β-lactam antibiotics is used most in clinical practice.
ObjectivesTo evaluate the current situation and rationality of electronic prescription in retail pharmacies in Chengdu, so as to provide references for further improving the sales of prescription drugs in retail drugstores and the level of rational drug use.MethodsA set of evaluation index system was constructed, and a prescription review group was set up. Eventually, 7 200 sample electronic prescriptions were collected for retrospective analysis and evaluation.ResultsPrescriptions from private medical institutions constituted the majority (3 543, 49.21%), and the majority of patients were junior and middle-aged, primarily respiratory diseases (38.24%) and circulatory diseases (17.11%), etc. The average quantity of drugs was 1.60 per prescription, percentage of antimicrobial use was 65.25%, percentage of essential medicines used was 34.92%, and reasonable rate of prescription was 95.21%.ConclusionsElectronic prescription services mode for retail pharmacy follows with the trend of “Internet + drug circulation” and complies with the rules of reasonable medical guidance and medication. However, optimizations are required, such as the lack of high-quality medical resources and the urgent need to optimize structure of prescription, and it is still essential to strengthen the management of antibacterial drugs and national essential medicines.
Objective To investigate drug usage and costs of children inpatients with bronchopneumonia in Karamay Central Hospital in 2014 and to provide baseline for evidence-based pharmacy study of single disease in respiratory system. Methods The information of drug use and expenditure of children inpatients with bronchopneumonia were collected from the hospital information system (HIS). We analyzed the data including frequency, proportion and cumulative proportion by Excel 2007 software. Results A total of 890 children inpatients were included, the average age was 1.00±2.17 years old. Among the antibiotics of single therapy, the frequency of amoxicillin and clavulanate potassium for injection was highest. Among the antibiotics of combination therapy, the frequency of macrolides was highest. Conclusion The mainly drugs for treatment of children inpatients with bronchopneumonia in Karamay Central Hospital in 2014 is amoxicillin and clavulanate potassium for injection.
Objective Inappropriate drug dosage is a serious problem in pediatrics, mainly due to the lack of clinical evidence in children, suitable preparation formulation, and standardized methods for dose adjustment. A method for evaluating and monitoring appropriate dosage in pediatrics is urgently needed. The drug utilization index (DUI) based on the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) has been widely used in the assessment of appropriate dosage in adults. We explored possible methods for assessing appropriate dosage in children. Methods Based on our previous studies, we discuss cDUI in the assessment of appropriate dosage in children as follows: the meaning of cDDD, the establishment of a standardized system, and the classified evaluation of dosage in pediatrics. Results Although the definition of cDDD draws on the concept of defined daily dose (DDD), the meaning of cDDD is different from that of the latter. Specifically, the purpose of cDDD is to evaluate appropriate pediatric dose, while DDD is a unit of measurement. cDDD could be used to assess dose rationality for common and serious pediatric diseases, and would be refined over time. A single cDDD should be assigned per drug and indication and given per drug and route of administration. The influence of age, weight, diagnosis, and administration route on the dosage should be considered. Classified evaluation should be used and weight should be given to the above mentioned factors in order to evaluate the appropriate dose objectively and comprehensively. Conclusion Dosage regulation in pediatrics has an important role in improving medical quality and protecting the safety, effectiveness, and economy of medical therapy in children. The establishment of a cDUI system is a good try in pediatric dosage evaluation. Although there are still defects within this proposed system and methodology, the principle seems feasible.
A total of 109 varieties of Chinese medicine injections have been approved by the State Food and Drug Administration of China, all of which have the potential to induce adverse drug reactions (ADRs). Major ADRs include systemic anaphylaxis, anaphylactic shock, acute intravascular hemolysis, hepatorenal damage, skin lesion, cardiac damage, respiratory system injury, and gastrointestinal disorders. Contributing factors of ADRs include healthcare workers’ inadequate attention to ADRs of Chinese medicine injections, complex ingredients, allergic uncertainties, and inappropriate drug use in children and the aged. To decrease ADRs resulting from Chinese medicine injections, it is essential to improve the selection of drug indications, delivery of proper dosage regimens, compliance with drug instructions, and selection of solvents for the drugs.