目的 調(diào)查武警河北省總隊(duì)醫(yī)院超藥品說明書用藥現(xiàn)狀，對存在的安全隱患進(jìn)行分析，提出防范建議，為降低用藥風(fēng)險(xiǎn)，規(guī)范管理提供理論依據(jù)。方法 對本院2019年1～12月門診處方、住院醫(yī)囑超說明書用藥情況進(jìn)行回顧性統(tǒng)計(jì)分析。結(jié)果 本院超說明書用藥主要表現(xiàn)在超適應(yīng)證、超適應(yīng)人群和給藥途徑等方面，90%以上超說明書用藥有證據(jù)支持，但也有部分超說明書用藥沒有指南推薦和文獻(xiàn)支持，藥品說明書之外的用法值得進(jìn)一步商榷。結(jié)論 超藥品說明書用藥現(xiàn)象客觀存在且不可避免，它涉及到藥品有效性、醫(yī)療執(zhí)業(yè)風(fēng)險(xiǎn)和安全隱患，因此制定合理的管理策略，強(qiáng)化超說明書用藥管理的規(guī)范化、制度化是當(dāng)前亟待解決的問題。

Objective To investigate the current status of the use of beyond the drug instructions, so as to analyze the security hidden danger, which provides the theoretical basis for reducing the risk of drug use and standardizing the management.Methods A retrospective statistical analysis was carried out on the prescriptions of outpatient and medical advice in a hospital in 2019. Results The main manifestations of off label drug use in the hospital are over indication, over adapted population and route of administration, More than 90% of off label drugs are supported by evidence, but some off label drugs are not recommended by guidelines and supported by literature. The usage of off label drugs is worthy of further discussion.Conclusion The phenomenon of off label drug use is objective and inevitable, which involves drug effectiveness, medical practice risk and safety risks. Therefore, it is urgent to formulate reasonable management strategies and strengthen the standardization and institutionalization of off label drug use management.

R969.3