The Cross-sectional Study Of Usage Of Auxiliary Drugs In Certain Provincial Hospital In Recent Four Years

Objective: We have investigated the auxiliary drug usage within the clinical departments of some provincial first-class hospitals at grade three for nearly four years using retrospective prescription statistics.By statistics prescription,prescription,prescription review and questionnaires,we have discussed the usage of types of adjuvant in these hospitals,aiming to find out unreasonable drug usage and improve the situation.Methods:1.We have retrospectively selected order lists within nearest four years in thirteen clinical departments differed from the traits,treatment methods and functional range of these departments,which can be divided into internal medicine,surgery group,thopaedic group and children group.According to the auxiliary drugs and drug ingredients,the drugs are divided into sorts of auxiliary anti-infection,blood circulation control,nutritional support and immune regulation,which results to the statistics within nearest four years of clinical departments of various kinds of auxiliary drug usage ratio and drug expense condition.2.Using the random number table method for all prescription to a random sample..Each department take 400 pieces,which contains supplementary anti-infection,promoting blood circulation to remove blood stasis,nutritional support and immune regulating auxiliary prescription drugs all 100 copies.For prescription reviews,statistics department assistant drug rational drug use rate in each group.3.By spot check of the unreasonable prescription,according to orders issued by doctors signature,the distribution of auxiliary drug use situation questionnaire,record the cause of the irrational use of auxiliary drugs.4.Choose some physicians,train them on the rational use of auxiliary drugs,and conduct the examination on the rational use of auxiliary drugs after the training.After the 8 physicians pass the examination,collect the prescriptions containing auxiliary drugs issued by them within one month,and make statistics on the changes of unreasonable drug use rate through prescription commentsResults:1.There have been 129316 patients admitted and cured in our 13 clinical departments during the recent 4 year,among those 94812 patients had taken auxiliary drugs,which illustrates the usage rate of auxiliary drugs reaches 76.95%;total expenditure has been 792.72 million RMB Yuan,among which expenses for auxiliary drugs have been 186.97 million RMB Yuan,accounting for 23.59%.During the recent four years,the cost of auxiliary drugs has been increasing constantly in the four groups of departments while the usage rate of auxiliary drugs and expenses for medicine have no significant changes(P > 0.05).2.We have randomly examined 1,600 pieces of prescriptions with auxiliary drug usage,among which 534 pieces are of irrational usage,occupying 33.7% overall,while there are 128 pieces of internal medicine ward,144 pieces of surgery ward,139 pieces of orthopedics ward and 123 pieces of gynecology ward.3.Irrational drug usage includes: no medication indications(25.23%),indication error(9.10%),dosing error(18.54),and excessive medication(47.13%).4.Cause of irrational prescription mainly includes: misunderstanding of drug indications(58,10.86%),randomly modifying of drug usage(253,47.38%),review after use not timely(208,38.95%),and input mistakes in doctor’s advice entry.After the training,the unreasonable utilization rate of adjuvant decreased obviously(13.61% vs 33.37%).Conclusions: currently,the usage rate of auxiliary drugs in provincial hospitals is pretty high and improper and excessive use is quite much common,mainly due to the knowledge misunderstanding of auxiliary drugs by clinicians to and incompetent understanding of medicine by both doctors and patients,which requires further correction.