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目的:分析上海市降压药物利用情况,并对各级医疗机构用药合理性进行评价。方法:对上海市医疗机构药品招标数据库中2013年11月—2014年10月一年期降压药的采购金额、单价、剂量等进行统计,采用世界卫生组织(WHO)推荐的用药频度(DDDs)和日均费用(DDDc)方法。结果:分析药物构成发现,上海市各级医疗机构降压药用药频率最高的为二氢吡啶类(36.17%),其次是ARB、固定配比复方制剂和ACEI;分析采购金额发现,一级、二级和三级医疗机构的降压药采购金额分别为13.83亿元、5.47亿元和6.36亿元;将DDDs值排序后发现,用药频率最高的药品为氨氯地平、左旋氨氯地平及缬沙坦等;各级医疗机构降压药采购的平均一致性为40.96%。结论:上海市高血压患者主要在社区配药,患者日治疗费用较为合理,但各级医疗机构药品采购一致性较差。
Objective: To analyze the use of antihypertensive drugs in Shanghai and to evaluate the rationality of drug use in medical institutions at all levels. Methods: The procurement amount, unit price and dosage of antihypertensive drugs in the drug bidding database of Shanghai Medical Institution from November 2013 to October 2014 were statistically analyzed. The frequency of drug use recommended by the World Health Organization (WHO) DDDs) and daily average cost (DDDc) methods. Results: Analysis of drug composition found that the highest frequency of antihypertensive drugs in medical institutions at all levels in Shanghai was dihydropyridines (36.17%), followed by ARB, fixed-dose combination preparations and ACEI; analysis of purchase amount found that first- The purchase amount of antihypertensive drugs in the secondary and tertiary medical institutions were respectively 1.383 billion yuan, 5.47 billion yuan and 6.36 billion yuan. According to the rankings of DDDs, the drugs with the highest frequency of drug use were amlodipine, levamlodipine and valor Sartan and so on; all levels of medical institutions antihypertensive drugs purchase the average consistency of 40.96%. Conclusion: Hypertensive patients in Shanghai are mainly in the community pharmacy, the patient day treatment costs more reasonable, but the medical institutions at all levels of drug procurement consistency is poor.