Analysis of rational use of medical orders of antitumor related drugs in a third-class hospital in 2023
LIU Yang1 YAO Zhihong1 LIU Ying1 YANG Juan2 ZHONG Ting2 CAI Jianhua2 REN Zhiqiang1
1.Clinical Pharmacy,Department of Pharmacy,Yiyang Central Hospital,Hunan Province,Yiyang 413000,China;
2.Medical Oncology Ward,Yiyang Central Hospital,Hunan Province,Yiyang 413000,China
Objective To analyze the rationality of clinical use of antitumor related drugs,and to provide reference for regulating physicians'prescribing behavior and promoting rational drug use.Methods In 2023,90 medical records of hospitalized patients using antitumor drugs in Yiyang Central Hospital were selected every quarter,and a total of 360 medical records were reviewed to analyze and evaluate their use.Results There were irrational use of antitumor drugs and their auxiliary drugs.Patients over 50 years old accounted for 72.12%of the unreasonable medical orders,and the departments were mainly distributed in the First Tumor Area,the Second Tumor Area and the Third General Surgery Department,accounting for 73.08%.According to the distribution of drug varieties,the top four irrational rates were Palonosetron (27.92%),Docetaxel (17.53%),Paclitaxel (albumin-bound) (11.04%) and Foxapitant (7.79%).The existing problems mainly include five aspects: inappropriate pretreatment,inappropriate usage and dosage,inappropriate route of administration,inappropriate anti-vomiting intensity and inappropriate solvent volume.Through the combination of real-time intervention by clinical pharmacists and medical quality evaluation,the unreasonable rate of medical orders (based on medical records)decreased from 35.56%in 2022 to 28.89%in 2023.Conclusion The deficiencies of clinical drug use can be found through the review of medical orders,and timely intervention measures can improve the level of clinical rational drug use.
Chen J,Pan Y.The safety and clinical efficacy of recombinant human granulocyte colony stimulating factor injection for colon cancer patients undergoing chemotherapy[J].Rev Assoc Med Bras(1992),2017,63(12):1061-1064.
Lin RJ,Adelman RD,Mehta SS.Dyspnea in palliative care:expanding the role of corticosteroids[J].J Palliat Med,2012,15(7):834-837.
[17]
Libert C,Dejager L.How steroids steer T cells[J].Cell Rep,2014,7(4):938-939.
[18]
Kathryn CA,Laura M,Niamh L,et al.Impact of Baseline Steroids on Efficacy of Programmed Cell Death-1 and Programmed Death-Ligand 1 Blockade in Patients With Non-Small-Cell Lung Cancer[J].J Clin Oncol,2018,36(28):2872-2878.
[19]
Olivia ML,Savanna B,Zihuai HE,et al.Do Steroids Matter?A Retrospective Review of Premedication for Taxane Chemotherapy and Hypersensitivity Reactions[J].J Clin Oncol,2021,39(32):3583-3590.
[20]
Santini FC,Rizvi H,Wilkins O,et al.Safety of retreatment with immunotherapy after immunerelated toxicity in patients with lung cancers treated with anti-PD(L)-1 therapy[J].J Clin Oncol,2017,35(15-suppl):9012.
[21]
Weber JS,Larkin JMG,Schadendorf D,et al.Management of gastrointestinal(GI)toxicity associated with nivolumab(NIVO)plus ipilimumab(IPI)or IPI alone in phase II and III trials in advanced melanoma(MEL)[J].J Clin Oncol,2017,35(15-suppl):9523.