| Objective:To observe the changes of the rational usage of diabetes drugs in patients with type 2 diabetes mellitus(T2DM)in a grade A tertiary general hospital in five years,so as to provide the references for the rational application of diabetes drugs.Methods:T2DM patients with complete medical records was collected through the hospital information management database from the Affiliated Hospital of Qingdao University.According to the usage time of diabetes drugs in the hospital,metformin(old drug),saxagliptin(sub-new drug)and dapaglifloz(new drug)were selected as the observation objects.Collect the relevant indicators and determine the basis of rational application of drugs whether the drugs were adjusted in time or forbidded to use according to the estimate glomerular filtration rate(eGFR)to observe the rational usage of diabetes drugs and analyze the changes in 5 years,so as to provide references for the clinical rational usage of diabetes drugs.Results:1.Metformin:(1)In this study,138 patients were collected from January 1 to May 31,2015,including 76 males(55.07%),62 females(44.93%),69.45±12.52 years old,8.21±1.77%of glycosylated hemoglobin A1c(Hb A1c),85.96±27.47μmol/L of serum creatinine(Scr),73.60±17.71ml/min/1.73m~2of eGFR,113 rational drug usage(81.88%)and 25 irrational drug usage(18.12%).A total of 274 patients were collected from January 1 to May 31,2020,including 161 males(58.76%),113 females(41.24%),63.69±10.75 years old,7.98±1.66%of Hb A1c,75.29±27.32μmol/L of Scr,85.47±23.33ml/min/1.73m~2of eGFR,247 rational drug usage(90.15%)and 27 irrational drug usage(9.85%).(2)Compared with T2DM patients in 2015,the proportion of rational usage of metformin in 2020 was increased significantly with statistical differences.(3)Irrational drug usage departments were mainly non-professional departments in 2015 and 2020.2.Saxagliptin:(1)In this study,128 patients were collected from January 1 to May 31,2015,including 65 males(50.78%),63 females(49.22%),65.36±12.81 years old,8.96±2.24%of Hb A1c,81.47±17.05μmol/L of Scr,77.84±17.77ml/min/1.73m~2of eGFR,124 rational drug usage(96.88%)and 4 irrational drug usage(3.12%).A total of 188 patients were collected from January 1 to May 31,2020,including 94 males(50.00%),94 females(50.00%),64.69±9.19 years old,8.09±1.87%of Hb A1c,80.51±30.40μmol/L of Scr,79.70±22.92ml/min/1.73m~2of eGFR,179 rational drug usage(95.21%)and 9 irrational drug usage(4.79%).(2)Compared with T2DM patients in 2015,the proportion of rational usage of saxagliptin in 2020 was declined without statistical differences.(3)Irrational drug usage departments were mainly professional departments in 2015 and non-professional departments in 2020.3.Dapaglifloz:(1)In this study,91 patients were collected from January 1 to May 31,2020,including 50 males(54.95%),41 females(45.05%),60.46±12.88 years old,8.58±0.20%of Hb A1c,70.59±2.84μmol/L of Scr,90.40±24.45ml/min/1.73m~2of eGFR,83 rational drug usage(91.21%)and 8 irrational drug usage(8.79%).(2)Irrational drug usage departments were mainly non-professional departments in 2015 and 2020.4.Metformin、saxagliptin and dapaglifloz:(1)In this study,412 patients were collected with metformina,including 360 rational drug usage(87.38%);316 patients were collected with saxaglipt,including 303 rational drug usage(95.89%);91 patients were collected with dapaglifloz,including 83 rational drug usage(91.21%).The differences between groups were statistical differences.(2)Compared with metformin,the rational drug usage rate of saxagliptin was higher in 2015 with statistical difference.(3)Saxagliptin had the highest proportion of rational drug usage,followed by dapaglifloz and the metformin lowest.(4)Irrational drug usage departments were non-professional departments.5.Scr and eGFR:In this study,a total of 819 T2DM patients were collected,including 32abnormal Scr(3.91%)and 787 normal Scr(96.09%),13 in which eGFR was up to45ml/min/1.73m~2(1.65%),103 in which eGFR was 45～60ml/min/1.73m~2(13.09%),375in which eGFR was 60～90ml/min/1.73m~2(47.65%)and 296 in which eGFR was90ml/min/1.73m~2or more(37.61%).In irrational drug usage group,the proportion of patients with normal Scr was higher.Conclusion:1.The rational rate of old drug(metformin)in a grade A tertiary general hospitals was increased compared to five years ago only from the eGFR.2.The rational rate of sub-new drug(saxagliptin)in a grade A tertiary general hospitals was declined compared to five years ago without statistical differences only from the eGFR.3.The rational rate of new drug(dapaglifloz)in a grade A tertiary general hospitals was high relatively only from the eGFR.4.Strengthen the drug management of non-professional departments,and the renal function should not be just judged by serum creatinine. |
PDF Full Text Request