Zheng Yuanyuan, Yin Yanhui, Liu Hong, Gao Wenwen, Wang Qian
Department of Pharmacy, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013, People's Republic of China.
The First Affiliated Hospital of Shandong First Medical University, Jinan, 250014, People's Republic of China.
Risk Manag Healthc Policy. 2025 Jul 9;18:2335-2350. doi: 10.2147/RMHP.S517679. eCollection 2025.
This study aimed to evaluate the rational use, safety, and economic implications of pentoxifylline in a hospital setting and provide recommendations for its appropriate clinical application.
A retrospective analysis was conducted on 322 patients discharged from September to December 2020, who received pentoxifylline. Data were collected from the hospital information system, and the rationality of prescriptions was assessed based on drug instructions and guidelines. Adverse drug reactions (ADRs) were analyzed using CTCAE criteria. Economic evaluations included defined daily dose cost (DDDc) and incremental cost-effectiveness ratio (ICER) analyses.
The rational prescription rate for pentoxifylline was 38.51%, with the main irrationalities observed in indications (31.82%), dosage and usage (21.21%), contraindications (47.98%), and drug combinations (40.40%). Adverse reactions were reported in 12 cases (3.73%), primarily involving the nervous (75.00%) and digestive systems (41.67%). Most ADRs were mild (58.33%) or moderate (41.67%), with no severe cases observed. The DDDc of pentoxifylline was 143.4 yuan. Cost-effectiveness analysis demonstrated strong economic viability, with ICER values of 55.7 yuan per percentage point improvement in ulcer healing rate and 9.0 yuan per additional meter of pain-free walking distance, significantly below the willingness-to-pay threshold.
Pentoxifylline demonstrates cost-effectiveness and manageable safety risks but has a low rational prescription rate, highlighting the need for improved clinical practices. Enhanced collaboration between pharmacists and medical staff, alongside stricter adherence to guidelines, is essential to optimizing its utilization.
本研究旨在评估己酮可可碱在医院环境中的合理使用、安全性及经济影响，并为其合理临床应用提供建议。
对2020年9月至12月出院的322例接受己酮可可碱治疗的患者进行回顾性分析。从医院信息系统收集数据，并根据药品说明书和指南评估处方合理性。使用CTCAE标准分析药物不良反应（ADR）。经济评估包括限定日剂量成本（DDDc）和增量成本-效果比（ICER）分析。
己酮可可碱的合理处方率为38.51%，主要不合理之处在于适应证（31.82%）、剂量和用法（21.21%）、禁忌证（47.98%）和药物联用（40.40%）。报告了12例不良反应（3.73%），主要累及神经（75.00%）和消化系统（41.67%）。大多数ADR为轻度（58.33%）或中度（41.67%），未观察到严重病例。己酮可可碱的DDDc为143.4元。成本-效果分析显示出较强的经济可行性，溃疡愈合率每提高一个百分点的ICER值为55.7元，无痛步行距离每增加一米的ICER值为9.0元，显著低于支付意愿阈值。
己酮可可碱具有成本效益且安全风险可控，但合理处方率较低，凸显了改进临床实践的必要性。药剂师与医务人员加强协作，同时更严格地遵守指南，对于优化其使用至关重要。
