| Objective To know the current application situation and trend of recombinant human interleukin-11(RhIL-11)and recombinant human thrombopoietin(Rh-TPO)in a hospital,we investigated all case in relation to the use of RhIL-11 and Rh-TPO in 2018 and 2019.We analyzed the influence factors of irrational RhIL-11 use in 2018 and 2019,and the intervention effect of clinical pharmacists on RhIL-11 use in the radiotherapy department in 2019,so that all doctors in the hospital could be provided a reference for the rational use of chemotherapyinduced thrombocytopenia(CIT)drugs.Methods The retrospective survey data of RhIL-11 and Rh-TPO in a hospital from January2018 to December 2019 was analyzed in descriptive statistical method.With reference to RhIL-11 instructions,clinical guidelines,expert consensus,and relevant domestic and foreign literature,we formulated RhIL-11 rationality evaluation indicators and corresponding evaluation rules.According to the evaluation rules,the questionnaire was formulated,and the cases of hospitalized tumor patients using RhIL-11 from January 2018 to December 2019 were selected.The cases that meet the inclusion criteria were filled in the questionnaire one by one,and the database was established.TOPSIS(technology for order preference by similarity to ideal solution)method based on AHM weighting is used to evaluate the rationality of RhIL-11 usage in a hospital in 2018 and 2019.In 2019,clinical pharmacists carried out some intervention measures,such as clinical lectures on RhIL-11 related information,RhIL-11 comments on doctor’s orders,participation in pharmaceutical rounds in the radiotherapy department in order to improve the rational use of RhIL-11.The changes of irrational use of RhIL-11 before and after intervention by clinical pharmacists in the radiotherapy department of a hospital were compared by TOPSIS method.Results According to the screening criteria,a total of 1316 patients used RhIL-11 and RhTPO were collected from 2018 to 2019.There are 557 patients using RhIL-11 and Rh-TPO in2018,and the ratio of tumor patients in whom were 83.66%(466/557).There are 759 patients using RhIL-11 and Rh-TPO in 2019,and the ratio of tumor patients in whom were 65.74%(499/759).Compared 2019 with 2018,the ratio of tumor patients in patients used RhIL-11 and Rh-TPO showed a decrease trend and the ratio of non-tumor patients in patients using RhIL-11 and Rh-TPO showed a increase trend(P<0.05).From 2018 to 2019,566 tumors patients were treated with RhIL-11,including 347 in 2018 and 219 in 2019.In 2018,the ratio of patients with reasonable medication was 12.97%(45/347),the ratio of patients with basically reasonable medication was 56.20%(195/347),and the ratio of patients with irrational medication was 30.84%(107/347).In 2019,the ratio of patients with reasonable medication was 8.68%(19/219),the ratio of patients with basically reasonable medication was 54.34%(119/219),and the ratio of patients with irrational medication was36.99%(81/219).Compared 2019 with 2018,the rationality proportion of RhIL-11 usage in all hospital showed a downward trend,but the difference was not statistically significant(P > 0.05).From 2018 to 2019,a total of 143 tumors patients were treated with RhIL-11 in the radiotherapy department,including 93 cases in 2018 and 50 cases in 2019.In 2018,the ratio of patients with reasonable medication was 6.45%(6/93),the ratio of patients with basically reasonable medication was 44.09%(41/93),and the ratio of patients with irrational medication was 49.46%(46/93).In 2019,the ratio of patients with reasonable medication was 12.00%(6/50),the ratio of basic reasonable medication was 56.00%(28/50),and the ratio of unreasonable medication was 32.00%(16/50).Compared 2019 with 2018,the rationality proportion of RhIL-11 usage in the radiotherapy department was significantly improved after the intervention of clinical pharmacists,and the difference was statistically significant(P<0.05).Conclusion This study shows that compared 2019 with 2018,the overall number of nontumor patients using RhIL-11 and Rh-TPO is significantly increased,which indicates that the RhIL-11 and Rh-TPO are used beyond the instructions.The number of tumor patients using RhIL-11 is decreasing rand the number of tumor patients using Rh-TPO is increasing compared2019 with 2018,which shows that doctors’ medication habits for CIT are gradually changing.Compared 2019 with 2018 on the rationality proportion of RhIL-11 usage,there is significantly improved in the department of radiotherapy after the intervention of clinical pharmacists,although there was no significant change in all hospital.Based on the current application situation of RhIL-11 in a hospital,it is still necessary to intervene the irrational use of RhIL-11 by the cooperation of multi-departments. |
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