基于指导方针使用质子抑制剂进行外科手术期间压力预防的实施:由CFIR-ERIC指导的前后研究
Xinrui Wang1, Ying Liu1, Yi Zhang1
1Department of Pharmacy, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China.
一项新的干预措施显著改善了对外科手术患者的质子抑制剂 (PPI) 的合理使用,减少了PPI的持续时间和成本. 这涉及过度使用PPI用于压力预防 (SUP).
科学领域:
- 药理学 药理学是指药理学的学科.
- 医疗保健 实施 科学 科学
- 临床医学 临床医学
背景情况:
- 过度使用和滥用质子抑制剂 (PPI) 用于术后患者的压力预防 (SUP) 是一个重大的临床问题.
- 这项研究解决了在这个脆弱的患者群体中改善PPI利用的需要.
研究的目的:
- 以"实施变化研究综合框架" (CFIR-ERIC) 专家推为指导,评估一种新型干预措施对在外科手术期间合理使用 PPI 的影响.
- 评估干预措施在减少不适当的PPI处方和相关成本方面的有效性.
主要方法:
- 北京朝阳医院采用了一个单一中心的前后研究设计.
- 接受CFIR-ERIC指导策略的干预组的倾向性得分与干预前病例的对照组相匹配.
- 测量结果包括合理的PPI使用率,不合理使用的原因,成本,PPI持续时间和定义的每日剂量.
主要成果:
- 干预组在合理使用PPI方面显著增加 (81.7%对42.0%,p<0.001).
- 干预后不适合使用,不适当剂量和管理的比例显著降低 (所有p<0.05).
- 虽然总住院和药物成本保持相似,但PPI成本 (¥7.44对¥93.70,p<0.001) 和定义的每日剂量 (7.00对8.00,p<0.001) 在干预组明显较低.
结论:
- 根据CFIR-ERIC指导的干预措施,有效地提高了针对外科手术期间SUP的PPI的合理使用.
- 该干预措施导致PPI持续时间和相关成本大幅减少,突出了其临床和经济效益.
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