某肿瘤医院白蛋白结合型紫杉醇合理应用评价标准的建立与应用

doi:10.3969/j.issn.2095-1264.2021.05.18

首页 > 过刊浏览>2021年第5期 >624-629. DOI:10.3969/j.issn.2095-1264.2021.05.18

某肿瘤医院白蛋白结合型紫杉醇合理应用评价标准的建立与应用
DOI:
                        10.3969/j.issn.2095-1264.2021.05.18
                    
作者:
                        
                        
                    
作者单位:湖南省肿瘤医院 药学部，湖南 长沙，410013
作者简介:刘芬，女，硕士，主管药师，研究方向：临床药学。
通讯作者:伍奕，男，硕士，主任药师，研究方向：临床药学。
中图分类号:R926
基金项目:★湖南省自然科学基金（2018JJ6032）；长沙市科技局基金（kq200431）。

Establishment and application of evaluation criteria on rational use of nab-paclitaxel in a cancer hospital^★

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Department of Pharmacy, Hunan Cancer Hospital, Changsha, Hunan, 410013, China

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摘要:

目的制定《白蛋白结合型紫杉醇合理应用评价标准》，分析湖南省肿瘤医院白蛋白结合型紫杉醇合理应用情况，为临床合理用药提供参考。方法参考药物利用评价（DUE）标准建立方法，结合中国、日本等国以及FDA白蛋白结合型紫杉醇药品说明书、NCCN指南、CSCO指南等，制定白蛋白结合型紫杉醇DUE标准，评价本院108例患者的白蛋白结合型紫杉醇应用情况。结果白蛋白结合型紫杉醇不合理应用主要表现在：适应症不合理51例（47.2%）、用法用量不合理43例（75.4%）、联合用药不合理10例（17.5%）、治疗周期内血常规监测不合理73例（67.6%）、止吐预处理不合理47例（43.5%）。超适应症使用比较普遍。108例点评病例中，符合说明书适应症9例（8.3%）、超适应症使用99例（91.7%），其中有循证医学证据的超适应症48例（48.5%）。结论本院建立的白蛋白结合型紫杉醇DUE标准有较好的实用性，可为临床合理用药提供参考。

Abstract:

Objective To establish the evaluation criteria on rational use of albumin-bound paclitaxel (nab-paclitaxel), and analyze the application of nab-paclitaxel in Hunan Cancer Hospital so as to provide reference for rational use of nab-paclitaxel.Methods Referring to drug utilization evaluation (DUE) criteria, the DUE criteria of nab-paclitaxel was established on the base of the specification approved by CFDA, FDA and PMDA, and NCCN and CSCO guidelines. And the use of nab-paclitaxel in 108 patients was evaluated according to the criteria.Results The main unreasonable applications of nab-paclitaxel were as follows: 51 cases (47.2%) were unreasonable in indications, 43 cases (75.4%) in usage and dosage, 10 cases (17.5%) in combination, 73 cases (67.6%) in routine blood monitoring during treatment period, and 47 cases (43.5%) in pretreatment for vomit-stopping. Off-label use was also common. Among the 108 reviewed cases, 9 cases (8.3%) had nab-paclitaxel used in line with the indications, but off-label use occurred in 99 cases (91.7%), including 48 cases (48.5%) of off-label use with evidence.Conclusion The established DUE criteria of nab-paclitaxel had a good practicability and were conducive to promote rational drug use in the clinic.