Vázquez-Mourelle Raquel, Carracedo-Martínez Eduardo
Assistant Manager. Galician Health Service. Xunta de Galicia. Santiago de Compostela, Galicia. Spain..
Organizational Structure of Integrated Management System. Galician Health Service. Santiago de Compostela, Galicia. Spain..
Farm Hosp. 2017 Jan 1;41(n01):49-67. doi: 10.7399/fh.2017.41.1.10559.
To analyze the impact of introducing omeprazole in the drug formulary of the Hospital de Barbanza on prescriptions made in hospital and out-of-hospital (Outpatient Units and Primary Care) for all Proton Pump Inhibitors (PPIs).
A 36-month retrospective descriptive study in a level I hospital. The basic units of work are Dose-Population- Day in the outpatient setting, and the Defined Daily Dose/stays-day for hospitalized patients; the proportion of DDDs for omeprazole vs. the rest of PPIs is used as measure of efficiency. For statistical analysis, we built a segmented regression model.
In the outpatient units, there are statistically significant changes for pantoprazole and rabeprazole. The first drug, which was stable before the intervention, suffered an immediate decrease; rabeprazole, which was increasing before the intervention, presented a subsequent downward trend. In Primary Care, a statistically significant change was confirmed for pantoprazole, with a long-term decreasing trend. In hospitalization, statistically significant changes were observed for pantoprazole and omeprazole; the first one with an immediate decrease and a long-term tendency to decrease, while omeprazole experienced an immediate increase and long-term growth. The evolution of the omeprazole percentage vs. all PPIs showed increases in all three scenarios.
A shift to a more efficient prescription of PPIs was observed in all healthcare settings following the introduction of omeprazole in the hospital drug formulary. The inclusion of efficient drugs, or the removal of those inefficient, can be a potentially useful tool in order to improve prescription profiles.
分析在巴尔班萨医院药品处方集里引入奥美拉唑对医院内及院外（门诊科室和初级保健机构）所有质子泵抑制剂（PPI）处方的影响。
在一家一级医院开展一项为期36个月的回顾性描述性研究。门诊环境下的基本工作单位是剂量-人群-日，住院患者的基本工作单位是限定日剂量/住院日；奥美拉唑与其他PPI的限定日剂量比例用作效率衡量指标。为进行统计分析，我们构建了一个分段回归模型。
在门诊科室，泮托拉唑和雷贝拉唑有统计学显著变化。第一种药物在干预前较为稳定，干预后立即下降；雷贝拉唑在干预前呈上升趋势，之后出现下降趋势。在初级保健机构，泮托拉唑有统计学显著变化，呈长期下降趋势。在住院治疗方面，泮托拉唑和奥美拉唑有统计学显著变化；前者立即下降且长期呈下降趋势，而奥美拉唑立即上升且长期增长。奥美拉唑占所有PPI的比例在所有三种情况下均呈上升趋势。
在医院药品处方集里引入奥美拉唑后，在所有医疗环境中都观察到向更高效的PPI处方转变。纳入高效药物或剔除低效药物可能是改善处方情况的一个潜在有用工具。
