中国药物警戒 ›› 2016, Vol. 13 ›› Issue (9): 563-566.

• 安全性评价与合理用药 • 上一篇    下一篇

基于2015比尔斯标准的门诊老年患者地高辛处方剂量分析

马丽萍, 杨菲, 蔡金蕊, 张文祥, 文程, 王海英*   

  1. 北京大学首钢医院,北京 100144
  • 收稿日期:2016-06-20 修回日期:2016-10-31 出版日期:2016-09-20 发布日期:2016-10-31
  • 通讯作者: 王海英,女,主任医师,医院药学管理。E-mail: haiying6572@sina.com。

Analysis of Digoxin Dose of Elderly Outpatient Prescriptions Based on 2015 Beers Criteria

MA Li-ping, YANG Fei, CAI Jin-rui, ZHANG Wen-xiang, WEN Cheng, WANG Hai-ying*   

  1. Peking University Shougang Hospital, Beijing 100144, China
  • Received:2016-06-20 Revised:2016-10-31 Online:2016-09-20 Published:2016-10-31

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摘要： 目的 为合理开具门诊老年患者（≥65岁）地高辛处方剂量提供参考。方法 收集2015年6月1日至2015年8月31日门诊含有地高辛的所有处方,根据美国老年医学会2015年比尔斯标准中地高辛的推荐剂量（不高于0.125 mg·d-1）,结合患者年龄,集中点评地高辛的处方剂量,并电话访谈患者,确认地高辛的实际服用剂量。结果 94张地高辛处方中,老年患者的处方共62张。处方剂量为0.50 mg·d-1、0.25 mg·d-1和≤0.125 mg·d-1分别占3.22%、90.32%和6.46% .而电话随访患者,地高辛的实际服用剂量为0.50 mg·d-1、0.25 mg·d-1和≤0.125 mg·d-1分别占0%、15.62%和84.38%。医生处方剂量（0.25 mg·d-1或0.5 mg·d-1）与处方后推荐患者服用的剂量(≤0.125 mg·d-1)不一致导致了处方中剂量与患者实际服用剂量的不一致。结论 我院地高辛规格单一、门诊药房不拆零和医院医嘱系统

关键词: 门诊老年患者, 地高辛处方, 2015比尔斯标准

Abstract: Objective To provide a basis for prescribing the rational digoxin dose for elderly outpatients. Methods All outpatients in Peking University shougang hospital who had been prescribed digoxin during 1 Jun. 2015 to 31 Aug. 2015 were eligible for the study. The samples were limited to adults aged 65 and older. The 2015 American Geriatrics Society (AGS) Beers Criteria was used to evaluate the doses of digoxin, which is recommended no more than 0.125 mg per day. The actual dosages of digoxin were confirmed with the included people by phone. Results Of 94 digoxin prescriptions, there are 62 prescriptions for elderly outpatients. Prescriptions of digoxin doses including 0.50 mg·d-1, 0.25 mg·d-1 and≤0.125 mg·d-1 account for 3.22%, 90.32% and 6.46%, respectively. However, by telephone interviewing some patients, we found that the actual doses of digoxin including 0.50 mg·d-1, 0.25 mg·d-1 and≤0.125 mg·d-1 account for 0%, 15.62% and 84.38%, respectively. We also found that the inconsistency between the doctor’s prescription doses (0.25 mg·d-1 or 0.5 mg·d-1) and the recommended doses (≤0.125 mg·d-1) was associated with the inconsistent dosage between the prescription doses of doctors and actual doses of patients. Conclusion Digoxin’ single strength, no unbundled dispensing medications of outpatient pharmacy and without limitation of digoxin dose for elderly outpatients in hospital information system are the main reasons of outpatient prescription digoxin doses higher than the recommended dose. Hence, the rationality of prescribing digoxin dose requires manufacturers, outpatient pharmacy, hospital information system and medical professionals to work together to make it.

Key words: elderly outpatient, digoxin prescription, 2015 Beers criteria

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