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美国成人重症监护药物短缺(2001-2016 年)。

U.S. drug shortages for medications used in adult critical care (2001-2016).

机构信息

Department of Emergency Medicine, MedStar Washington Hospital Center, 110 Irving Street NW, Washington, DC 20010, United States; Georgetown University School of Medicine, 3900 Reservoir Road, Washington, DC 20007, United States.

Department of Emergency Medicine, MedStar Washington Hospital Center, 110 Irving Street NW, Washington, DC 20010, United States; Georgetown University School of Medicine, 3900 Reservoir Road, Washington, DC 20007, United States.

出版信息

J Crit Care. 2017 Oct;41:283-288. doi: 10.1016/j.jcrc.2017.06.005. Epub 2017 Jun 9.

Abstract

PURPOSE

We describe trends in U.S. shortages impacting critical care drugs from 2001 to 2016.

MATERIALS AND METHODS

Shortages within the scope of critical care were identified using data from the University of Utah Drug Information Services. Shortage characteristics were described using standard descriptive statistics and regression analysis.

RESULTS

Of 1969 shortages reported, 1004 (51%) were for drugs used in critical care. New shortages fell from 2001 to 2004, then increased, peaking in 2011 (116). For critical care shortages, 247 (24.6%) involved drugs used for high acuity conditions. The majority of drugs on shortage were parenteral, (720; 71.7%) and 393 (39.1%) were single source drugs. Alternatives were available for 887 (88.3%) drugs, although 250 (24.9%) alternatives were impacted by shortages. Infectious disease drugs were the most common drugs on shortage, with 200 (19.9%) shortages, with a median duration of 7.7months (IQR=2.8-17.3). By the end of the study, 896 (89.2%) shortages were resolved and 108 (10.8%) remained active. The median duration for active shortages was 13.6months (IQR=5.8-58.4) while the duration for resolved shortages was 7.2months (IQR=2.8-17.3).

CONCLUSIONS

Although the number of new shortages peaked in 2011 and is now declining, there remain a substantial number of active shortages impacting critical care drugs.

摘要

目的

描述 2001 年至 2016 年美国影响重症监护药物短缺的趋势。

材料与方法

利用犹他大学药物信息服务的数据,确定重症监护范围内的短缺情况。使用标准描述性统计和回归分析描述短缺特征。

结果

在报告的 1969 次短缺中,有 1004 次(51%)是用于重症监护的药物。新短缺从 2001 年至 2004 年下降,然后增加,在 2011 年达到峰值(116 次)。对于重症监护短缺,有 247 次(24.6%)涉及用于高 acuity 情况的药物。短缺的药物中,大部分是肠外药物(720 种;71.7%),393 种(39.1%)是单一来源药物。虽然有 250 种(24.9%)替代品受到短缺影响,但 887 种(88.3%)药物有替代品。传染病药物是最常见的短缺药物,有 200 种(19.9%)短缺,平均持续时间为 7.7 个月(IQR=2.8-17.3)。研究结束时,896 种(89.2%)短缺已解决,108 种(10.8%)仍在持续。活跃短缺的中位数持续时间为 13.6 个月(IQR=5.8-58.4),而已解决短缺的持续时间为 7.2 个月(IQR=2.8-17.3)。

结论

尽管新短缺数量在 2011 年达到峰值,现在正在下降,但仍有大量活跃的短缺影响重症监护药物。

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