Domínguez J C, Nieto P, Guerra F, Beltrán C, Molina T, Hidalgo M L, Martín E, Martínez M C, Cano M
Distrito Sanitarios Sevilla Sur-Guadalquivir-San Juan, Este, Aljarafe.
Aten Primaria. 1995 Jul-Aug;16(3):137-40.
To find the reasons for prescription of Ticlopidine, which acts against the aggregation of platelets and is catalogued as "with hospital diagnosis", and to evaluate the criteria for its correct use and whether it is actually used in Spain to treat authorised symptoms.
A descriptive, crossover and retrospective study.
Primary Care districts in the catchment area of the Virgen del Rocío hospital in Sevilla.
Those who requested permits for Ticlopidine prescriptions, documented by the clinical report.
The following data were recorded from the clinical reports presented when the Ticlopidine prescription permits were requested: patient's identification, diagnosis, pharmaceutical speciality, dosage, length of treatment and recommendation of haematological check-ups. Out of 407 reports available, the diagnosis corresponded to one of the authorised symptoms in 50.6% of cases. In a third of the patients the recommended dose was half that endorsed by the published clinical trials. Only in 2.7% of cases was mention made of the desirability of having haematological check-ups to forestall possible adverse reactions. The possibility of a counter-indication to Acetylsalicylic acid was only rarely mentioned.
Ticlopidine is recommended in 50% of cases for symptoms for which it is not authorised in our country: moreover, in 35% of cases, at doses lower than those established as effective. The information given by the doctor who initiates the treatment is usually insufficient. There is a need to reassess whether cataloguing a medicine as "with hospital diagnosis" aids its rational use.
找出开具抗血小板聚集药物噻氯匹定（该药被归类为“需医院诊断”用药）的原因，评估其正确使用标准，以及该药在西班牙是否实际用于治疗获批症状。
描述性、交叉性和回顾性研究。
塞维利亚罗西奥圣母医院服务区域内的初级保健区。
那些申请噻氯匹定处方许可的患者，有临床报告为证。
从申请噻氯匹定处方许可时提交的临床报告中记录以下数据：患者身份、诊断、药学专业、剂量、治疗时长及血液学检查建议。在可得的407份报告中，50.6%的病例诊断符合获批症状之一。三分之一患者的推荐剂量为已发表临床试验认可剂量的一半。仅2.7%的病例提及为预防可能的不良反应进行血液学检查的必要性。很少提及对乙酰水杨酸禁忌的可能性。
在50%的病例中，噻氯匹定被用于治疗我国未获批的症状；此外，35%的病例使用的剂量低于已确定的有效剂量。开始治疗的医生提供的信息通常不足。有必要重新评估将一种药物归类为“需医院诊断”用药是否有助于其合理使用。
