目的:了解安徽医科大学第一附属医院(以下简称"我院")生殖医学中心门诊医嘱用药情况,探讨超说明书用药的合理性及相关对策,为临床合理用药提供参考.方法:回顾性分析2016年我院生殖医学中心门诊随机抽取的用药医嘱77776条,以药品说明书为依据,参照《处方管理办法》,对其中的超说明书用药医嘱进行统计分析,并根据相关诊疗规范、临床指南和专家共识、循证医学或文献探讨超说明书用药医嘱的合理性.结果:77776条用药医嘱中,超说明书用药医嘱33239条(占42.74％);超说明书用药类型主要包括超适应证、超剂量和(或)超频次、超给药途径和超禁忌证等;超说明书应用黄体酮注射液的医嘱共13272条(占超说明书用药医嘱的39.93％),多为超剂量用药.结论:2016年我院生殖医学中心门诊超说明书用药情况比较普遍.根据相关药物使用说明、既往研究报告、相关专家共识及循证医学证据分析可见,大部分超说明书用药基本合理,但仍存在一定的用药风险.建议相关部门制定有效措施,保障临床合理用药.%OBJECTIVE:To investigate the drug application of outpatient medical orders in reproductive medicine center of department of gynecology and obstetrics in the First Affiliated Hospital of Anhui Medical University ( hereinafter referred to as "our hospital") , to discuss the rationality of off-label medication and related countermeasures , so as to provide references for clinical rational medication . METHODS: 77776 outpatients medication orders in reproductive medicine center of department of gynecology and obstetrics in our hospital in 2016 were randomly extracted and retrospectively analyzed , off-label medical orders therein were collected and analyzed on the basis of dispensatory and relevant regulations in "Prescription Administrant Policy", and the rationality of off-label medication orders were discussed according to relevant rules of diagnosis and treatment , clinical guidelines and consensus from specialists , evidence-based medicine or related literatures .RESULTS: Of 77776 medication orders , there were 33239 off-label medication orders ( 42.74％); types of off-label medication orders mainly including overindication, overdose and (or) overfrequency, off-route of administration and off-contraindication, etc;there were 13272 off-label medication orders ( 39.93％) with application of progesterone injection , mostly were overdose medication .CONCLUSIONS: Off-label medication in outpatient of reproductive medicine center of department of gynecology and obstetrics is slightly prevalent in our hospital in 2016 .According to instructions of relevant drugs , previous research reports and consensus from related specialists , most off-label medications are basically rational , however , there is still a certain medication risk .Effective measures are suggested to be formulated to ensure clinical rational medication .
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