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正确使用Pabrinex:一项多循环质量改进研究减少了在苏格兰地区总医院处方胺的浪费
Thomas W Noteman1, Damien McCoy1
1General Medicine, Inverclyde Royal Hospital, Greenock, GBR.
Cureus
|November 10, 2025
概括
这项质量改进项目减少了对酒精使用障碍患者的不必要的静脉注射Pabrinex处方. 基于教育的干预措施显著降低了多余的胺剂量,改善了处方实践.
科学领域:
- 内部医学 内部医学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 患有酒精使用障碍 (AUD) 的患者面临维尼克脑病变 (WE) 的高风险,原因是胺缺乏.
- 不适当治疗WE可以导致不可逆转的Korsakoff综合征.
- 过度使用静脉注射 (IV) 硫胺类药物,如Pabrinex,会造成巨大的成本和资源负担.
研究的目的:
- 在住院AUD患者中量化和减少不必要的IVPabrinex处方.
- 使用计划-做-研究-行动 (PDSA) 方法实施和评估一个多周期质量改进 (QI) 项目.
- 评估针对处方医生的教育干预措施对胺处方实践的影响.
主要方法:
- 在4个月内对106名AUD入院患者进行了回顾性研究.
- 对处方者进行了两次教育干预.
- 对处方IVPabrinex剂量的数据与当地指导方针进行了比较,以确定过量使用.
- 主要结局包括过量剂量的数量和接受正确初始剂量的患者比例.
主要成果:
- 基线数据显示,60%的患者接受过多的IVPabrinex剂量,平均每患者超过13剂.
- 在干预后,每个患者过量剂量的中位数显著下降至4.5 (p=0.0087).
- 接受正确初始剂量的患者比例从30%增加到51.3%,尽管这在统计学上并不显著 (p=0.12).
结论:
- 一个多循环的QI项目有效地减少了AUD患者不必要的IVPabrinex过度处方.
- 低成本,专注于处方者的教育可以改善胺替代疗法实践.
- 进一步的研究应考虑临床结果和概括性,同时确保适当的胺治疗以防止剂量不足.
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