Application Status And Drug Utilization Research Of Immunoenhancers In One Hospital

Ovjective:The purpose of this study was to investigate the current situation and developing trend of drug utilization of immunoenhancers in our hospital of three consecutive years, to evaluate the drug utilization and analyze the influencing factors of inappropriate utilization, in order to offer the managerial and professional recommendations for safe, effective and economical use of drugs and promote the rational use of drugs.Methods:1. Immunoenhancers used from2010to2012were analyzed with the methods of amount of sorting, DDDs and statistical description.2. We selected the cases of patients who used immunoenhancers by simple random sampling from July2011to June2012, and then conducted a retrospective review to assess the rationality of immunoenhancers.3. SPSS(version17.0)was used for statistical analyses, the influencing factors of inappropriate drug utilization were analyed using unconditional logistic regression analysis.Results:1. The sales amount of immunoenhancers showed an increasing trend from the year2010to2012, the annual growth rate were19.3%, 25.7%respectively. The biological agent of immunoenhancers accounted for the largest proportion of overall sales amount; the sales amount of Lentinan(for injection) during three consecutive years were22.73%,26.32%,22.77%respectively. By the year2012, sales amount of Lentinan rose to number one, and Bozhi Glycopetide injection rose from eight to two.2. The mainly indications of immunoenhancers are malignant tumor65.1%(631/969), infectious disease14.2%(138/969) and autoimmune disease4.7%(46/969), which are consist of Chinese Pharmacopoeia. The most widely used three departments are special department, general surgery department and chemotherapy department.3. The irrational use of immunoenhancers prescriptions accounted for42.3%(410/969) of969patients, and the irrational ratio was33.7%(474/1408) of1408cases. The top three immunoenhancers of irrational ratio in descending order were:thymosin96.9%(124/128), lentinan49.2%(117/238), recombinant human interleukun-234.8%(46/132).4. Ranked according to the proportion of irrational use, the mainly three unreasonable forms of1408immunoenhancer cases were:wrong dosage of administration28.5%(135/474), wrong frequency of administration27.6%(131/474), and wrong course of administration19%(90/474). The irrational prescriptions are mainly distributed in chemotherapy department71.7%(71/99), special department62.3%(109/175), and general surgery department40.3%(50/124).5. In hospital costs, the percentage of immunoenhaner costs to western medicine costs was most controlled by less than20%, accounting for70.5%(683/969). With immunoenhancer associated with an increase in number of other species, the percentage will increase conrespondingly.6. Multivariate unconditional logistic regression analysis showed that patients use the conservative treatment, suffers the infectious diseases, cancer, autoimmune diseases and check in ICU are protection facotors; the more immunoenhancers types combined, the higher rate of irrational drug use.Conclusion:1. The sales amount of immunoenhancers showed an increasing trend from the year2010to2012, and the irrational drug use was commonly existed during cinical application. The irrational forms mainly as follows:dosage, frequency and course of administration.2. Multivariate unconditional logistic regression analysis showed that the conservative treatment, check the ICU, risk of infectious, cancer, autoimmune diseases, and the combination are related with irrational drug use.3. The irrational drug use of immunoenhancers are widely exixterd in clinical application, we recommended that the administrative department of health, specialized committee are reasonable for making relevant regulations and technical specifications; medical institutions should develop regulations and systems, conduct a special reviews and inspection, to regulate drug use behaviors and promote the irrational use of medicines.