某综合医院门诊抗抑郁药处方调查及用药合理性分析

摘要

Objective To understand the application and rationality of antidepressant drugs in a general hospital, and to provide a basis for improving the drug delivery of antidepressant and medication monitoring. Methods Totally 798 outpatient prescriptions of antidepressant in December 2016 were randomly selected, and the condition of drug use was analyzed. Results In the 798 antidepressant prescriptions, 21 patients with obsessive - compulsive disorder, mood disorder and other mental disorders and 4 patients with postherpetic neuralgia, enuresis and other non anxiety or depression were eliminated according to the diagnosis, 773 cases were selected, including 204 cases of anxiety or depression, 569 cases of somatic disease associated with anxiety and depression, 315 males(40. 75％ ) and 458 females(59. 25％ ) . Anxiety or depression was mostly concentrated in the age of 18 - 44 years old. The prescription mainly comes from the Department of Neurology, Department of Psychology and the Department of Gastroenterology, which accounted for 90. 04％ . The single use of antidepressants was mainly used, the rates of anxiety and depression in the two combinations and combination of antipsychotic pre-scriptions accounted for 20. 59％ and 43. 14％ , respectively, which were higher than 8. 44％ and 6. 15％ of somatic disease associated with anxiety and depression. The appropriateness of drug use was mainly manifested in unsuitable usage and dosage(27 cases), inappropriate drug selection ( 29 cases ) , and unsuitable drug use ( 22 cases) . Conclusion There are still a few cases of inappropriate antidepressant prescriptions in the Department of Outpatient in the hospital. It is suggested that pharmaceutical care and medication education should be strengthened to improve the quality of the prescription, so as to ensure the safety of drug use.%目的 了解某综合医院门诊抗抑郁药的使用情况及其合理性,为完善抗抑郁药发药交代和用药监护资料提供参考.方法 随机抽取医院2016年12月含抗抑郁药的门诊处方798张,对用药情况进行分析.结果 798张抗抑郁药处方中,根据诊断剔除强迫症、心境障碍等精神障碍患者21例及带状疱疹后神经痛、遗尿等非焦虑或抑郁患者4例,共纳入处方773张,其中焦虑或抑郁204例,躯体疾病伴发焦虑抑郁569例;男315例(40.75％),女458例(59.25％);焦虑或抑郁多集中在18～44岁;处方主要来源于神经内科、心理科和消化内科,共占90.04％;以单用抗抑郁药为主,二联使用、合用抗精神病药处方中焦虑或抑郁分别占20.59％和43.14％,高于躯体疾病伴发焦虑抑郁的占8.44％和6.15％;用药适宜性主要表现为用法用量不适宜(27例)、药物选用不适宜(29例)、联合用药不适宜(22例).结论 医院门诊抗抑郁药处方仍存在少数不适宜用药情况,建议加强药学监护及用药教育,提高处方质量,以确保用药安全.