Analysis on the application of oral anticoagulants in respiratory diseases in six cities in China from 2013 to 2017_West China Medical Journal

Authors：

ZHANG Jingyi ,  XU Ting , QIN Zhou , WU Bin , YAN Yu

Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

XU Ting, Email: tingx2009@163.com

Keywords：

Oral anticoagulant; Drug consumption sum; Number of prescription; Prescribed daily dose; Defined daily dose

DOI：

10.7507/1002-0179.201812077

Video：

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Objective To realize the application status and development trend of oral anticoagulant drugs used in respiratory diseases in 72 hospitals in 6 cities from the year 2013 to 2017.Methods From January 2013 to December 2017, we randomly selected the electronic information from 10 working days per quarter in 6 cities including Beijing, Guangzhou, Shanghai, Chengdu, Shenyang, and Zhengzhou, with 12 hospitals in each city, and summarized the information into the prescription database of the hospital prescription analysis project. Through the hospital information system, we screened out the information of outpatient prescriptions and inpatient medical records which used oral anticoagulants. The prescriptions with respiratory diseases related-diagnosis were selected as the research objects by manual screening. The application of oral anticoagulant drugs used in respiratory diseases was statistically analyzed by drug amount, prescription amount, prescribed daily dose (PDD), and defined daily dose (DDD).Results From 2013 to 2017, the number of warfarin sodium prescriptions was successively 4 769, 5 747, 7 549, 7 261, and 7 151, which had been always ranked the first in the five years, but decreased year by year since 2015. The proportion of warfarin sodium drug use amount decreased year by year from 32.52% in 2013 to 5.03% in 2017. The proportion of prescription and drug consumption sum of new oral anticoagulants increased year by year in the past five years. The PDD/DDD of warfarin sodium, dabigatran etexilate, rivaroxaban, and apixaban were 0.41, 0.73, 0.68, and 0.33, respectively. There were off lable use of new oral anticoagulants.Conclusions Warfarin still dominates the proportion of oral anticoagulants prescribed in the 72 hospitals in the 6 cities in the five years. The clinicians have made a comprehensive judgment after fully considering the safety, effectiveness, and economy of drug use when formulating drug treatment programs.

Citation： ZHANG Jingyi, XU Ting, QIN Zhou, WU Bin, YAN Yu. Analysis on the application of oral anticoagulants in respiratory diseases in six cities in China from 2013 to 2017. West China Medical Journal, 2019, 34(1): 22-29. doi: 10.7507/1002-0179.201812077 Copy

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1. 董軍, 劉寅. 抗凝藥物的進展及臨床應用. 中華老年心腦血管病雜志, 2013, 15(12): 1333-1335.
2. 黃海彬, 盧曉霞, 邱倩倩, 等. 抗凝藥物臨床應用的研究進展. 海峽藥學, 2013, 25(6): 1-4.
3. 任小嬋, 羅選娟, 楊歡, 等. 新型口服抗凝藥的臨床應用研究進展. 中華全科醫學, 2018, 16(4): 615-619, 666.
4. World Health Organization. Introduction to drug utilization research 2003. Oslo, Norway: 2003. http://apps.who.Int/medicinedocs/en/d/Js4876e/7.html.
5. 陳新謙, 金有豫, 湯光. 新編藥物學. 17 版. 北京: 人民衛生出版社, 2011: 536-537.
6. 羅文蘋. 新型口服抗凝藥在治療血栓栓塞性疾病中的研究進展. 重慶: 重慶醫科大學, 2015.
7. 杜昕, 郭偉. 新型口服抗凝藥是否可以取代華法林用于靜脈血栓栓塞癥抗凝治療. 中國血管外科雜志: 電子版, 2016, 8(3): 178-182.
8. 中華醫學會心血管病學分會, 中國老年學學會心腦血管病專業委員會. 華法林抗凝治療的中國專家共識. 中華內科雜志, 2013, 52(1): 76-82.
9. 何培根, 閔新文, 鄭芳, 等. 華法林鈉藥理作用影響因素與華法林鈉用藥監護. 醫藥導報, 2011(5): 668-671.
10. Rieder MJ, Reiner AP, Gage BF, et al. Effect of VKORC1 haplotypes on transcriptional regulation and warfarin dose. N Engl J Med, 2005, 352(22): 2285-2293.
11. 徐建華, 鄒穎. 胺碘酮可增強華法林的抗凝作用分析. 南通大學學報: 醫學版, 2012, 32(3): 243-244.
12. 張先龍. 新型口服抗凝藥物阿哌沙班. 中華關節外科雜志: 電子版, 2014(4): 543-546.
13. Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest, 2016, 149(2): 315-352.
14. 中國健康促進基金會血栓與血管專項基金專家委員會, 中華醫學會呼吸病學分會肺栓塞與肺血管病學組, 中國醫師協會呼吸醫師分會肺栓塞與肺血管病工作委員會. 醫院內靜脈血栓栓塞癥防治與管理建議. 中華醫學雜志, 2018, 98(18): 1383-1388.
15. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace, 2016, 18(11): 1609-1678.
16. 馬軍, 吳一龍, 秦叔逵, 等. 腫瘤相關靜脈血栓栓塞癥的預防與治療中國專家指南(2015版). 中國腫瘤臨床, 2015, 43(20): 979-991.
17. 中華人民共和國衛生部. 處方管理辦法. (2007-02-14)[2018-12-11]. http://www.gov.cn/flfg/2007-03/13/content_549406.htm.
18. 中華人民共和國衛生部, 國家中醫藥管理局, 總后勤部衛生部. 醫療機構藥事管理規定. (2011-11-30)[2018-12-01]. http://www.nhfpc.gov.cn/mohyzs/s3585/201103/51113.shtml.
19. 全國人民代表大會常務委員會. 中華人民共和國侵權責任法. (2009-12-26)[2018-12-01]. http://www.gov.cn/flfg/2009-12/26/content_1497435.htm.
20. 覃濤, 樊榮, 何紀毅. 超說明書用藥合法嗎?. 中國醫院院長, 2018(19): 84-87.

West China Medical Journal

Analysis on the application of oral anticoagulants in respiratory diseases in six cities in China from 2013 to 2017

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