摘要
目的探讨国家药品集中采购政策对门诊高血压患者用药方案的影响,为提高医疗服务水平积累经验。方法回顾性分析2019年1—12月天津市蓟州区人民医院门诊就医的82例高血压患者,均由硝苯地平控释片(非集采)单药调整为集采药品联合用药治疗。观察1组患者42例,给予苯磺酸氨氯地平片(集采)+福辛普利钠片(集采)(方案一),观察2组患者40例,给予苯磺酸氨氯地平片(集采)+坎地沙坦酯片(集采)(方案二),对比两组患者改变治疗方案前、后血压水平、控制有效率及不良反应发生率,并进行成本-效果(C/E)分析。结果调整治疗方案前两组血压水平对比,差异无统计学意义(P>0.05)。调整治疗方案后两组舒张压较前降低,差异均有统计学意义(P<0.05)。调整治疗方案前两组血压控制有效率对比,差异无统计学意义(P>0.05)。调整治疗方案后两组血压控制有效率均较前提高,差异均有统计学意义(P<0.05);调整治疗方案前两组不良反应发生率为9.52%、10.00%,差异无统计学意义(P>0.05)。调整治疗方案后两组不良反应发生率为4.76%、5.00%,均较前降低,差异均有统计学意义(P<0.05)。调整治疗方案前两组C/E为2.44、2.39,差异无统计学意义(P>0.05);调整治疗方案后两组C/E为0.54、0.19,均较原方案降低,差异均有统计学意义(P<0.05)。结论降压药物实施国家集中采购政策后,门诊医生对高血压患者的处方时具有更多选择,在保证降压效果的同时降低了不良反应发生率,且所担负费用更低,值得推广应用。
Objective To investigate the effect of national drug centralized policy on the medication regimen of outpatients with hypertension,to accumulate experience to improve the level of medical services.Methods A retrospective analysis was conducted of 82 hypertensive patients who were treated at the outpatient clinic of Tianjin Jizhou District People's Hospital from January to December 2019,all of whom were treated with nifedipine controlled-release tablets(non-centralized procurement)monotherapy to combination therapy with centralized drug procurenment.Forty-two patients in observation group 1,were given amlodipine besylate tablets(centralized procurement)+fosinopril sodium tablets(centralized procurement)(plan 1),and 40 patients in observation group 2 were given amlodipine besylate tablets(centralized procurement)+candesartan cilexetil tablets(centralized procurement)(plan 2).The control of blood pressure and the incidence of adverse reactions were compared between the two groups before and after changing the treatment plan,and a cost-effectiveness(C/E)analysis was performed.Results There was no statistically significant difference in blood pressure levels between the two groups before adjusting the treatment plan(P>0.05).After adjusting the treatment plan,the diastolic blood pressure of the two groups were lower than before,and the differences were statistically significant(P<0.05).Before adjusting the treatment plan,there was no significant difference in the effective rate of blood pressure control between the two groups(P>0.05).After adjusting the treatment plan,the effective rate of blood pressure control in the two groups were higher than before,and the diferences were statistically significant(P<0.05).Before adjusting the treatment plan,the incidence of adverse reactions in the two groups was 9.52%and 10.00%,and the difference was not statistically significant(P>0.05).After adjusting the treatment plan,the incidence of adverse reactions in the two groups was 4.76%and 5.00%,both of which were lower than before,and the differences were statistically significant(P<0.05).Before adjusting the treatment plan,the C/E of the two groups were 2.44 and 2.39,and the difference was not statistically significant(P>0.05).After adjusting the treatment plan,the C/E of the two groups were 0.54 and 0.19,which were both lower than before,and the differences were statistically significant(P<0.05).Conclusion After the implementation of the national centralized procurement policy for antihypertensive drugs,outpatient doctors had more choices when prescribing for hypertensive patients.While ensuring the antihypertensive effect,the incidence of adverse reactions was reduced,and the cost was lower,which was worthy of promotion and application.
作者
阮建佳
杜岩
RUAN Jian-jia;DU Yan(Department of Comprehensive Internal Medicine,Tianjin Jizhou District People's Hospital,Tianjin 301900,China;Department of Pharmacy,Tianjin Jizhou District People's Hospital)
出处
《中国城乡企业卫生》
2023年第9期110-113,共4页
Chinese Journal of Urban and Rural Enterprise Hygiene
关键词
高血压
国家药品集中采购
苯磺酸氨氯地平片
福辛普利钠片
坎地沙坦酯片
Hypertension
National drug centralized procurement
Amlodipine besylate tablets
Fosinopril sodium tablets
Candesartan cilexetil tablets
作者简介
阮建佳,本科,主治医师,主要从事内科临床诊治工作;通信作者:杜岩,E-mail:wangyiaruan@163.com。
