Utilization Status And Rationality Analysis Of Drugs To Patients With Diabetes From 2013 To 2015 In A Second Class General Hospital

Objective: To investigate the Utilization Status of Patients with Diabetes from 2013 to 2015 in a Second Class General Hospital, comprehend the application characteristics of oral hypoglycemic agents and insulin, analysis whether the rationality of medication is consistent with the requirements of the guidelines or not, provide the improvement suggestion for the unreasonable phenomenon, provide scientific basis for the rational use of hypoglycemic agents, and the supervision and administration for the relevant departments.Methods: 1. Spot-check the drug names, specification, dosage, cost, combined medication and so on depending on the annual data of hypoglycemic agents that included HIS system from 2013 to 2015 in one hospital. According to the figure sequencing method and frequency analysis method recommended by WHO, using Microsoft Excel 2007, analyzing the sales amount, DDDs, DDC and the situation of combined medication etc. Then we make a quantitative analysis about the oral hypoglycemic agents and insulin, summarize and discuss the characteristics and trends of drug use in the treatment of diabetes. 2. By retrospective analysis, 579 patients hospitalized with diabetes from January 2013 to December 2015 in the hospital were involved. The patients' fundamental status, disease diagnosis, oral hypoglycemic drugs, insulin and drugs for complications,combined medication were recorded. According to the guidelines, relevant literature and drug prescriptions, data processing was calculated by Microsoft Excel 2007. We acquaint the current situation and tendency of hypoglycemic agents in the hospital as well as assessing the appropriateness of those drugs used to the Diabetes patients.Results: 1. The consumption sum of hypoglycemic agents were 8.31 million yuan, 8.42 million yuan and 10.16 million yuan during 2013-2015, The amount increased quickly year by year. Their consumption sum rank was strongly aligned and well-synchronized with DDDs rank by category. The top three were insulin, biguanides and ?-glucosidase inhibitor. Insulin sales amount dominated the first place all the time. Insulin's ratio in total hypoglycemic agents was: 46.53%(2013), 41.40%(2014), 46.52%(2015). Metformin and acarbose remained at the first and second place in the oral hypoglycemic agents' total DDDs rank. Their summation of DDDs constituent ratio is almost 70%; Imported drugs always occupied the top position market; DDDc and the rank status of all the hypoglycemic agents leveled off among the three years; Long-acting insulin analogues was in a downward trend. The premixed insulin and rapid-acting insulin dominated the top two in the insulin use in the hospital. 2. In the study of 579 cases, there were 4454 treatment orders. According to statistical analysis on the data attained, 39 orders were irrational, representing 0.88% of total orders. The irrational orders were showed below: drugs selection were inappropriate, dosage or usage was inappropriate, repeated medication, unreasonable combined administration and adverse reaction etc. Under the active participation of clinical pharmacists, the unreasonable utilization rate decreased from 1.46% in 2013 to 0.42% in 2015, which presented downward tendency.Conclusions: 1. The consumption sum and DDDs of hypoglycemic agents increased year by year within 2013-2015. DDC ranking situation remained relatively stable during the three years. Insulin dominated the list of the hypoglycemic agents, which proved that the insulin had an irreplaceable role. The diversified therapy formula of insulin and the combined therapy with oral hypoglycemic agents, promoted the treatment effect of diabetes. 2. Metformin and acarbose were frequently used oral antidiabetics. The consumption sum of insulin secretagogues growed quickly, the use of insulin secretagogues will expand in clinic. Import drugs were used generally. Penetration rate of the drugs at patients' own expense is low. The utilization of hypoglycemic agents in the hospital was rational. 3. Clinicians can develop individualized therapies depending on the condition of patients. The results show the usage of anti-diabetic medicine in the hospital is generally reasonable. To sum up, there are many kinds of drugs in the treatment of diabetes, which should be selected according to the characteristics of the drug and the patient's condition, in order to reduce the irrational use.