真实临床烧伤药物治疗的药物流行病学分析

O. Zhukova, E. Nekaeva, E. S. Khoroshavina, E. Kozlova, Y. Dudukina, Igor Yuryevich Arefyev
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摘要

目的:在考虑俄罗斯联邦中心真实住院临床实践中药物实际消耗情况的情况下,进行药物流行病学分析和药物治疗费用分析。材料和方法。分析了2018年住院的14名烧伤患者的医疗记录数据。患者年龄23 ~ 67岁(44,93±14,66)。住院时间17 ~ 62天(35,93±14,17)。我们计算了每种药物的处方率及其在所有已使用疗程的总体结构中的份额(n = 460)。进行处方结构频次分析、限定日剂量(DDD)分析、药物利用(DU90%)分析、abc分析和药物治疗平均费用分析。使用率最高的药物有15种,如2种抗菌药物(万古霉素和阿米卡星);常用的药物有19种,包括4种抗菌药物(复方新诺明、头孢哌酮/舒巴坦、替加环素和头孢吡肟)。使用其他药物的病例不到25%。33种药物占NDDD总消耗量的90%,包括5种抗菌药物(万古霉素、阿米卡星、复方新诺明、头孢哌酮/舒巴坦和替加环素)。这些药物占处方结构的70.24%。DU90%段的DDD成本(512,33卢布)比DU10%段(649,34卢布)高1.4。DU90%组药品平均费用为4735、89卢布,而DU10%组药品平均费用为4966、80卢布。这一发现显示了烧伤药物治疗的积极趋势。我们获得的数据,可以用于比较真实的临床实践成本与当前支付率的医疗保健。
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Pharmacoepidemiological Analysis of Pharmacotherapy for Burn Injuries in Real Clinical Practice
Objective: to conduct pharmacoepidemiological analysis and analysis of the costs of pharmacotherapy, taking into account the actual consumption of drugs in the real inpatient clinical practice at the federal center in Russia. Materials and methods. Data from the medical records of 14 patients with burn injury, who were hospitalized in 2018, was analyzed. Patients’ age was from 23 to 67 years (44,93 ± 14,66). Duration of hospitalization was from 17 to 62 days (35,93 ± 14,17). We calculated rate of prescription foe each drug and its share in general structure of all utilized drug courses (n = 460). We performed frequency analysis of prescription structure, DDD (defined daily doses) analysis, DU90% (Drug Utilization 90%) analysis, ABC-analysis and analysis of average cost of pharmacotherapy. Results. Most frequently used drugs, prescribed in 75-100% of all hospital cases, included 15 names, e.g. 2 antimicrobial drugs (vancomycin and amikacin), 19 were used commonly, including 4 antimicrobial drugs (co-trimoxazole, cefoperazone/sulbactam, tigecyclin and cefepime). Other drugs were used in less than 25% of cases. 33 drugs made 90% of all consumed NDDD, including 5 antimicrobial drugs (vancomycin, amikacin, co-trimoxazole, cefoperazone/sulbactam and tigecyclin). These drugs comprised 70,24% in the prescription structure. The cost of one DDD in DU90% segments (512,33 rubles) is 1,4 higher than in DU10% segment (649,34 rubles). Average cost of drugs included in DU90% group was 4735,89 rubles vs 4966,80 rubles for drugs from DU10% group. This finding shows positive tendency of burn injuries pharmacological treatment. Conclusion. We obtained the data, which can be used for comparison of real clinical practice costs with a current payment rates for medical care.
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