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Article(id=1239268419560854357, tenantId=1146029695717560320, journalId=1205117082300743687, issueId=1239268417962832543, articleNumber=null, orderNo=null, doi=10.14109/j.cnki.xyylc.2024.07.13, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1677168000000, receivedDateStr=2023-02-24, revisedDate=null, revisedDateStr=null, acceptedDate=1713974400000, acceptedDateStr=2024-04-25, onlineDate=1773394215717, onlineDateStr=2026-03-13, pubDate=1721836800000, pubDateStr=2024-07-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773394215717, onlineIssueDateStr=2026-03-13, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773394215717, creator=13701087609, updateTime=1773394215717, updator=13701087609, issue=Issue{id=1239268417962832543, tenantId=1146029695717560320, journalId=1205117082300743687, year='2024', volume='43', issue='7', pageStart='481', pageEnd='560', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773394215336, creator=13701087609, updateTime=1773394445099, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1239269381725810851, tenantId=1146029695717560320, journalId=1205117082300743687, issueId=1239268417962832543, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1239269381725810852, tenantId=1146029695717560320, journalId=1205117082300743687, issueId=1239268417962832543, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=551, endPage=555, ext={EN=ArticleExt(id=1239268419787346774, articleId=1239268419560854357, tenantId=1146029695717560320, journalId=1205117082300743687, language=EN, title=Investigation and analysis on drug-related problems of new oral anticoagulants in hospitalized patients, columnId=1239222198267867866, journalTitle=Chinese Journal of New Drugs and Clinical Remedies, columnName=Rational Drug Use, runingTitle=null, highlight=null, articleAbstract=
AIM

To investigate the use of new oral anticoagulants (NOACs) and clinically relevant drug-related problems (DRPs) in hospitalized patients, in order to provide a reference for promoting the rational use of NOACs.

METHODS

A total of 586 medical records of inpatients using NOACs at the First Affiliated Hospital of Anhui Medical University from October 2021 to September 2022 were collected. Retrospective reviews were conducted according to relevant guidelines and regulations. The summary analysis of the observed DRPs was performed with reference to the criteria used in the Chinese Classification System for Drug-Related Problems (V1.0), which is adapted to the Chinese population and healthcare model.

RESULTS

Among the 586 cases, the majority were females (52.4%), and the average age was (69.5±12.6) years old. The most common indication for the use of NOACs was nonvalvular atrial fibrillation (272 cases, 46.4%), which involved three varieties and eight criteria. DRPs occurred in 358 patients, with a total of 389 DRPs identified, including 213 (54.8%) DRP1.1, 72 (18.5%) DRP2.1, 4 (1.0%) DRP3.1, 65 (16.7%) DRP3.2, and 35 (9.0%) DRP3.3.

CONCLUSION

The use of NOACs in our hospital are mainly manifested as low single doses, infrequent administration, and lack of indication for medication.

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目的

探讨住院患者新型口服抗凝药物（NOACs）的使用情况和临床应用药物相关问题（DRPs），为促进NOACs的合理使用提供参考。

方法

收集安徽医科大学第一附属医院2021年10月至2022年9月使用NOACs的住院患者病历共586份，依据相关指南、法规等对其进行回顾性点评，参考符合中国人群和医疗模式的《中国药物相关问题分类系统（V1.0）》使用标准对所发现的DRPs汇总分析。

结果

586份住院病历中，女性居多（52.4%），年龄为（69.5±12.6）岁，使用NOACs最常见的病因是非瓣膜性心房颤动（272例，46.4%），涉及3个品种、8个品规；其中358例患者发生了DRPs，累计发生389个DRPs，包括213个（54.8%）DRP1.1、72个（18.5%）DRP2.1、4个（1.0%）DRP3.1、65个（16.7%）DRP3.2和35个（9.0%）DRP3.3。

结论

本院NOACs的使用问题主要表现为单次剂量过低、给药频次过少及无指征用药。

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杨翠，女，主管药师，硕士，主要从事临床药学的研究，E-mail：

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Effectiveness and safety of direct oral anticoagulants versus warfarin in patients with valvular atrial fibrillation: a population-based cohort Study [J]. Ann Intern Med, 2021, 174（7）: 910-919., articleTitle=Effectiveness and safety of direct oral anticoagulants versus warfarin in patients with valvular atrial fibrillation: a population-based cohort Study, refAbstract=null), Reference(id=1239268423818073035, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2016, volume=5, issue=2, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[2], rfOrder=1, authorNames=LUIGI DB, journalName=J Am Heart Assoc, refType=null, unstructuredReference=LUIGI DB. Use of direct oral anticoagulants in patients with atrial fifibrillation and valvular heart lesions [J]. J Am Heart Assoc,2016, 5（2）: e002776., articleTitle=Use of direct oral anticoagulants in patients with atrial fifibrillation and valvular heart lesions, refAbstract=null), Reference(id=1239268423910347733, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=1990, volume=47, issue=3, pageStart=533, pageEnd=543, url=null, language=null, rfNumber=[3], rfOrder=2, authorNames=HEPLER CD, STRAND LM, journalName=Am J Hosp Pharm, refType=null, unstructuredReference=HEPLER CD, STRAND LM. Opportunities and responsibilities in pharmaceutical care [J]. Am J Hosp Pharm, 1990, 47（3）: 533-543., articleTitle=Opportunities and responsibilities in pharmaceutical care, refAbstract=null), Reference(id=1239268423994233819, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2019, volume=null, issue=null, pageStart=26, pageEnd=27, url=null, language=null, rfNumber=[4], rfOrder=3, authorNames=李 达, 闫素英, journalName=药物治疗管理教学与实践手册, refType=null, unstructuredReference=李 达, 闫素英. 药物治疗管理教学与实践手册 [M]. 北京:人民卫生出版社, 2019: 26- 27., articleTitle=null, refAbstract=null), Reference(id=1239268424082314209, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2014, volume=36, issue=4, pageStart=345, pageEnd=348, url=null, language=null, rfNumber=[5], rfOrder=4, authorNames=谢升阳, 倪 阳, 王玮琴, journalName=浙江医学, refType=null, unstructuredReference=谢升阳, 倪 阳, 王玮琴, 等. 药物相关问题分类系统的研究进展 [J]. 浙江医学, 2014, 36（4）: 345-348., articleTitle=药物相关问题分类系统的研究进展, refAbstract=null), Reference(id=1239268424149423078, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2014, volume=36, issue=4, pageStart=345, pageEnd=348, url=null, language=null, rfNumber=[5], rfOrder=5, authorNames=XIE SY, NI Y, WANG WQ, journalName=Zhejiang Med, refType=null, unstructuredReference=XIE SY, NI Y, WANG WQ, et al. Research progress in classification system of drug-related problems [J]. Zhejiang Med, 2014, 36（4）: 345-348., articleTitle=Research progress in classification system of drug-related problems, refAbstract=null), Reference(id=1239268424233309164, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2022, volume=56, issue=8, pageStart=1042, pageEnd=1049, url=null, language=null, rfNumber=[6], rfOrder=6, authorNames=廖 赟, 张 萍, journalName=中华预防医学杂志, refType=null, unstructuredReference=廖 赟, 张 萍.《中国药物相关问题分类系统（V1.0）》使用标准 [J]. 中华预防医学杂志, 2022, 56（8）: 1042-1049., articleTitle=《中国药物相关问题分类系统（V1.0）》使用标准, refAbstract=null), Reference(id=1239268424329778158, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2022, volume=56, issue=8, pageStart=1042, pageEnd=1049, url=null, language=null, rfNumber=[6], rfOrder=7, authorNames=LIAO Y, ZHANG P, journalName=Chin J Prev Med, refType=null, unstructuredReference=LIAO Y, ZHANG P. Standard for the use of the Chinese classification system for drug-related problems [J]. Chin J Prev Med, 2022, 56（8）: 1042-1049., articleTitle=Standard for the use of the Chinese classification system for drug-related problems, refAbstract=null), Reference(id=1239268424401081331, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2022, volume=26, issue=1, pageStart=15, pageEnd=88, url=null, language=null, rfNumber=[7], rfOrder=8, authorNames=黄从新, 张 澍, 华 伟, journalName=中华心律失常学杂志, refType=null, unstructuredReference=黄从新, 张 澍, 华 伟. 心房颤动：目前的认识和治疗建议（2021）[J]. 中华心律失常学杂志, 2022, 26（1）: 15-88., articleTitle=心房颤动：目前的认识和治疗建议（2021）, refAbstract=null), Reference(id=1239268424501744638, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2022, volume=26, issue=1, pageStart=15, pageEnd=88, url=null, language=null, rfNumber=[7], rfOrder=9, authorNames=HUANG CX, ZHANG S, HUA W, journalName=Chin J Cardiac Arrhyth, refType=null, unstructuredReference=HUANG CX, ZHANG S, HUA W. Current knowledge and management of atrial fibrillation: consensus of Chinese experts 2021[J]. Chin J Cardiac Arrhyth, 2022, 26（1）: 15-88., articleTitle=Current knowledge and management of atrial fibrillation: consensus of Chinese experts 2021, refAbstract=null), Reference(id=1239268424577241094, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2021, volume=23, issue=3, pageStart=185, pageEnd=192, url=null, language=null, rfNumber=[8], rfOrder=10, authorNames=林庆荣, 杨明辉, 候志勇, journalName=中华创伤骨科杂志, refType=null, unstructuredReference=林庆荣, 杨明辉, 候志勇. 中国创伤骨科患者围术期静脉血栓栓塞症预防指南（2021） [J]. 中华创伤骨科杂志, 2021, 23（3）: 185-192., articleTitle=中国创伤骨科患者围术期静脉血栓栓塞症预防指南（2021）, refAbstract=null), Reference(id=1239268424665321484, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2021, volume=23, issue=3, pageStart=185, pageEnd=192, url=null, language=null, rfNumber=[8], rfOrder=11, authorNames=LIN QR, YANG MH, HOU ZY, journalName=Chin J Orthop Trauma, refType=null, unstructuredReference=LIN QR, YANG MH, HOU ZY. Guidelines for prevention of perioperative venous thromboembolism in Chinese orthopedic trauma patients （2021） [J]. Chin J Orthop Trauma,2021, 23（3）: 185-192., articleTitle=Guidelines for prevention of perioperative venous thromboembolism in Chinese orthopedic trauma patients （2021）, refAbstract=null), Reference(id=1239268424753401875, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2022, volume=7, issue=1, pageStart=12, pageEnd=29, url=null, language=null, rfNumber=[9], rfOrder=12, authorNames=吴丹明, journalName=中华血管外科杂志, refType=null, unstructuredReference=吴丹明. 常见静脉疾病诊治规范（2022年版）[J]. 中华血管外科杂志, 2022, 7（1）: 12-29., articleTitle=常见静脉疾病诊治规范（2022年版）, refAbstract=null), Reference(id=1239268424828899349, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2022, volume=7, issue=1, pageStart=12, pageEnd=29, url=null, language=null, rfNumber=[9], rfOrder=13, authorNames=WU DM, journalName=Chin J Vasc Surg, refType=null, unstructuredReference=WU DM. Diagnostic and therapeutic norms for common venous diseases （2022 edition） [J]. Chin J Vasc Surg, 2022, 7（1）: 12-29., articleTitle=Diagnostic and therapeutic norms for common venous diseases （2022 edition）, refAbstract=null), Reference(id=1239268424921174046, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2019, volume=39, issue=6, pageStart=501, pageEnd=532, url=null, language=null, rfNumber=[10], rfOrder=14, authorNames=马青变, 郑亚安, 朱继红, journalName=中国急救医学, refType=null, unstructuredReference=马青变, 郑亚安, 朱继红, 等. 中国急性血栓性疾病抗栓治疗共识 [J]. 中国急救医学, 2019, 39（6）: 501-532., articleTitle=中国急性血栓性疾病抗栓治疗共识, refAbstract=null), Reference(id=1239268425013448741, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2019, volume=39, issue=6, pageStart=501, pageEnd=532, url=null, language=null, rfNumber=[10], rfOrder=15, authorNames=MA QB, ZHENG YA, ZHU JH, journalName=Chin J Crit Care, refType=null, unstructuredReference=MA QB, ZHENG YA, ZHU JH, et al. Consensus on antithrombotic treatment of acute thrombotic diseases in China [J]. Chin J Crit Care, 2019,39（6）: 501-532., articleTitle=Consensus on antithrombotic treatment of acute thrombotic diseases in China, refAbstract=null), Reference(id=1239268425101529129, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2017, volume=42, issue=1, pageStart=58, pageEnd=63, url=null, language=null, rfNumber=[11], rfOrder=16, authorNames=VIPREY M, JEANNIN R, PIRIOU V, journalName=J Clin Pharm Ther, refType=null, unstructuredReference=VIPREY M, JEANNIN R, PIRIOU V, et al. Prevalence of drug-related problems associated with direct oral anticoagulants in hospitalized patients: a multicenter, cross-sectional study [J]. J Clin Pharm Ther, 2017, 42（1）: 58-63., articleTitle=Prevalence of drug-related problems associated with direct oral anticoagulants in hospitalized patients: a multicenter, cross-sectional study, refAbstract=null), Reference(id=1239268425197998129, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2020, volume=23, issue=10, pageStart=1971, pageEnd=2029, url=null, language=null, rfNumber=[12], rfOrder=17, authorNames=王声祥, 任艳平, 李 楠, journalName=中国药师, refType=null, unstructuredReference=王声祥, 任艳平, 李 楠, 等. 新型口服抗凝药治疗非瓣膜病房颤的成本-效用分析 [J]. 中国药师, 2020, 23（10）:1971-2029., articleTitle=新型口服抗凝药治疗非瓣膜病房颤的成本-效用分析, refAbstract=null), Reference(id=1239268425319632951, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2020, volume=23, issue=10, pageStart=1971, pageEnd=2029, url=null, language=null, rfNumber=[12], rfOrder=18, authorNames=WANG SX, REN YP, LI N, journalName=China Pharmacist, refType=null, unstructuredReference=WANG SX, REN YP, LI N, et al. Cost-utility analysis of novel oral anticoagulants in the treatment of non-valvular atrial fibrillation [J]. China Pharmacist, 2020, 23（10）: 1971-2029., articleTitle=Cost-utility analysis of novel oral anticoagulants in the treatment of non-valvular atrial fibrillation, refAbstract=null), Reference(id=1239268425428684860, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2020, volume=40, issue=2, pageStart=208, pageEnd=212, url=null, language=null, rfNumber=[13], rfOrder=19, authorNames=王声祥, 任艳平, 李 楠, journalName=中国医院药学杂志, refType=null, unstructuredReference=王声祥, 任艳平, 李 楠, 等. 阿哌沙班、利伐沙班、达比加群酯、依诺肝素预防髋膝关节置换术后静脉血栓形成的成本-效果分析 [J]. 中国医院药学杂志, 2020, 40（2）: 208-212., articleTitle=阿哌沙班、利伐沙班、达比加群酯、依诺肝素预防髋膝关节置换术后静脉血栓形成的成本-效果分析, refAbstract=null), Reference(id=1239268426502426694, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2020, volume=40, issue=2, pageStart=208, pageEnd=212, url=null, language=null, rfNumber=[13], rfOrder=20, authorNames=WANG SX, REN YP, LI N, journalName=Chin J Hosp Pharm, refType=null, unstructuredReference=WANG SX, REN YP, LI N, et al. Cost-effectiveness evaluation of apixaban rivaroxaban dabigartan in the prevention of venous thromboembolism after total hip and knee arthropalsty [J]. Chin J Hosp Pharm, 2020, 40（2）: 208-212., articleTitle=Cost-effectiveness evaluation of apixaban rivaroxaban dabigartan in the prevention of venous thromboembolism after total hip and knee arthropalsty, refAbstract=null), Reference(id=1239268426565341257, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2016, volume=38, issue=11, pageStart=2477, pageEnd=2488, url=null, language=null, rfNumber=[14], rfOrder=21, authorNames=MCHORNEY CA, PETERSON ED, LALIBERTE F, journalName=Clin Ther, refType=null, unstructuredReference=MCHORNEY CA, PETERSON ED, LALIBERTE F, et al. Comparison of adherence to rivaroxaban versus apixaban among patients with atrial fibrillation [J]. Clin Ther, 2016, 38（11）:2477-2488., articleTitle=Comparison of adherence to rivaroxaban versus apixaban among patients with atrial fibrillation, refAbstract=null), Reference(id=1239268426628255822, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2023, volume=13, issue=1, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[15], rfOrder=22, authorNames=ARNAR BI, JOHANN PH, SIGRUN HL, journalName=BMJ Open, refType=null, unstructuredReference=ARNAR BI, JOHANN PH, SIGRUN HL, et al. Comparison of medication adherence to different oral anticoagulants: population-based cohort study [J]. BMJ Open, 2023, 13（1）: e065700., articleTitle=Comparison of medication adherence to different oral anticoagulants: population-based cohort study, refAbstract=null), Reference(id=1239268426699558993, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2022, volume=20, issue=9, pageStart=1608, pageEnd=1611, url=null, language=null, rfNumber=[16], rfOrder=23, authorNames=王晓玲, 李晓慧, 梁 海, journalName=中华全科医学, refType=null, unstructuredReference=王晓玲, 李晓慧, 梁 海, 等. 基于Granada-Ⅱ分类法对临床应用利伐沙班药物相关问题的评价[J]. 中华全科医学,2022, 20（9）: 1608- 1611., articleTitle=基于Granada-Ⅱ分类法对临床应用利伐沙班药物相关问题的评价, refAbstract=null), Reference(id=1239268426787639382, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2022, volume=20, issue=9, pageStart=1608, pageEnd=1611, url=null, language=null, rfNumber=[16], rfOrder=24, authorNames=WANG XL, LI XH, LANG H, journalName=Chin Gen Prac, refType=null, unstructuredReference=WANG XL, LI XH, LANG H, et al. Evaluation of drug-related problems in clinical application of rivaroxaban based on Granada-Ⅱ classification[J]. Chin Gen Prac, 2022, 20（9）: 1608- 1611., articleTitle=Evaluation of drug-related problems in clinical application of rivaroxaban based on Granada-Ⅱ classification, refAbstract=null), Reference(id=1239268426875719774, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2019, volume=8, issue=21, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[17], rfOrder=25, authorNames=CHAN YH, LEE HF, WANG CL, journalName=J Am Heart Assoc, refType=null, unstructuredReference=CHAN YH, LEE HF, WANG CL, et al. Comparisons of rivaroxaban following different dosage criteria （ROCKET AF or J-ROCKET AF Trials） in Asian patients with atrial fibrillation [J]. J Am Heart Assoc, 2019, 8（21）: e013053., articleTitle=Comparisons of rivaroxaban following different dosage criteria （ROCKET AF or J-ROCKET AF Trials） in Asian patients with atrial fibrillation, refAbstract=null), Reference(id=1239268426959605857, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2019, volume=50, issue=9, pageStart=2574, pageEnd=2577, url=null, language=null, rfNumber=[18], rfOrder=26, authorNames=CHENG WH, CHAO TF, LIN YJ, journalName=Stroke, refType=null, unstructuredReference=CHENG WH, CHAO TF, LIN YJ, et al. Low-dose rivaroxaban and risks of adverse events in patients with atrial fibrillation [J]. Stroke, 2019, 50（9）: 2574-2577., articleTitle=Low-dose rivaroxaban and risks of adverse events in patients with atrial fibrillation, refAbstract=null), Reference(id=1239268427035103335, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2019, volume=171, issue=3, pageStart=181, pageEnd=189, url=null, language=null, rfNumber=[19], rfOrder=27, authorNames=HA JT, NEUEN BL, CHENG LP, journalName=Ann Intern Med, refType=null, unstructuredReference=HA JT, NEUEN BL, CHENG LP, et al. Benefits and harms of oral anticoagulant therapy in chronic kidney disease [J]. Ann Intern Med, 2019, 171（3）: 181-189., articleTitle=Benefits and harms of oral anticoagulant therapy in chronic kidney disease, refAbstract=null), Reference(id=1239268427228041326, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2020, volume=75, issue=3, pageStart=273, pageEnd=285, url=null, language=null, rfNumber=[20], rfOrder=28, authorNames=KUNO T, TAKAGI H, ANDO T, journalName=J Am Coll Cardiol, refType=null, unstructuredReference=KUNO T, TAKAGI H, ANDO T, et al. Oral anticoagulation for patients with atrial fibrillation on long-term dialysis [J]. J Am Coll Cardiol, 2020, 75（3）: 273-285., articleTitle=Oral anticoagulation for patients with atrial fibrillation on long-term dialysis, refAbstract=null), Reference(id=1239268427328704632, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2022, volume=22, issue=4, pageStart=437, pageEnd=444, url=null, language=null, rfNumber=[21], rfOrder=29, authorNames=HERALD J, GOITIA J, DUAN L, journalName=Am J Cardiovasc Drugs, refType=null, unstructuredReference=HERALD J, GOITIA J, DUAN L, et al. Safety and effectiveness of direct oral anticoagulants versus warfarin for treating left ventricular thrombus [J]. Am J Cardiovasc Drugs, 2022, 22（4）: 437-444., articleTitle=Safety and effectiveness of direct oral anticoagulants versus warfarin for treating left ventricular thrombus, refAbstract=null), Reference(id=1239268427462922365, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, doi=null, pmid=null, pmcid=null, year=2021, volume=52, issue=2, pageStart=517, pageEnd=522, url=null, language=null, rfNumber=[22], rfOrder=30, authorNames=BASS ME, KISER TH, PAGE RL 2nd, journalName=J Thromb Thrombolysis, refType=null, unstructuredReference=BASS ME, KISER TH, PAGE RL 2nd, et al. Comparative effectiveness of direct oral anticoagulants and warfarin for the treatment of left ventricular thrombus [J]. J Thromb Thrombolysis,2021, 52（2）: 517-522., articleTitle=Comparative effectiveness of direct oral anticoagulants and warfarin for the treatment of left ventricular thrombus, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1239268420278080353, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, xref=null, ext=[AuthorCompanyExt(id=1239268420286468962, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, companyId=1239268420278080353, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Pharmacy, the First Affiliated Hospital of Anhui Medical University/Anhui Public Health Clinical Center, Hefei ANHUI 230012, China), AuthorCompanyExt(id=1239268420294857571, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, companyId=1239268420278080353, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=安徽医科大学第一附属医院/安徽省公共卫生临床中心 药学部，安徽 合肥　230012)])], figs=[ArticleFig(id=1239268423113429918, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
科室利伐沙班阿哌沙班达比加群酯占比/%
心血管内科13417636.0
骨科2110019.1
普外科630110.9
呼吸与危重症医学科48069.2
肿瘤科29005.0
血液内科21054.4
中医科17303.4
神经内科12153.1
肾内风湿科10101.9
康复医学科4111.0
其他29066.0
合计369117100100.0
), ArticleFig(id=1239268423209898912, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, language=CN, label=表1, caption=

NOACs临床使用科室分布情况

, figureFileSmall=null, figureFileBig=null, tableContent=
科室利伐沙班阿哌沙班达比加群酯占比/%
心血管内科13417636.0
骨科2110019.1
普外科630110.9
呼吸与危重症医学科48069.2
肿瘤科29005.0
血液内科21054.4
中医科17303.4
神经内科12153.1
肾内风湿科10101.9
康复医学科4111.0
其他29066.0
合计369117100100.0
), ArticleFig(id=1239268423281202087, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
项目问题利伐沙班阿哌沙班达比加群酯占比/%
DRP1.1药物治疗无效/不佳19315554.8
DRP2.1可能发生药物不良反应事件630918.5
DRP3.1有未治疗的适应证0041.0
DRP3.2无指征用药4023216.7
DRP3.3不确定的问题，需要进一步说明，无法明确进行分类时22859.0
合计3184625100.0
), ArticleFig(id=1239268423402836909, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, language=CN, label=表2, caption=

新型口服抗凝药（NOACs）临床应用药物相关问题（DRPs）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目问题利伐沙班阿哌沙班达比加群酯占比/%
DRP1.1药物治疗无效/不佳19315554.8
DRP2.1可能发生药物不良反应事件630918.5
DRP3.1有未治疗的适应证0041.0
DRP3.2无指征用药4023216.7
DRP3.3不确定的问题，需要进一步说明，无法明确进行分类时22859.0
合计3184625100.0
), ArticleFig(id=1239268423486722994, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
原因编码分组数量占比/%
药物不良反应C1.1药物本身属性（药品未知的特性、药品质量等）41.0
C1.2患者特殊生理因素（患者自身未知的特殊体质等）20.5
信息获得C2.1药品信息未被提供10.2
C2.6药物重整10.2
药物选择C3.1品种选择错误或不适宜348.1
C3.5药物与药物/草药/保健品联用不适宜61.4
C3.7同一疾病使用药物种类过多102.4
C3.8有适应证，但未给予药物治疗，或药物治疗方案不完整41.0
C3.9无指征用药6716.0
用法用量C4.1单次剂量过低17341.2
C4.2单次剂量过高102.4
C4.3给药频次过少6716.0
C4.4给药频次过多81.9
疗程C5.1疗程短41.0
医嘱/处方执行C6.1医嘱/处方开具或下发时人为的操作错误20.5
C6.10流程监管或制度管理相关（特殊使用药品、自备药、保管等）225.2
其他C8.3其他原因；详细说明51.2
合计420100.0
), ArticleFig(id=1239268423595774908, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239268419560854357, language=CN, label=表3, caption=

新型口服抗凝药（NOACs）的药物相关问题原因及分组

, figureFileSmall=null, figureFileBig=null, tableContent=
原因编码分组数量占比/%
药物不良反应C1.1药物本身属性（药品未知的特性、药品质量等）41.0
C1.2患者特殊生理因素（患者自身未知的特殊体质等）20.5
信息获得C2.1药品信息未被提供10.2
C2.6药物重整10.2
药物选择C3.1品种选择错误或不适宜348.1
C3.5药物与药物/草药/保健品联用不适宜61.4
C3.7同一疾病使用药物种类过多102.4
C3.8有适应证，但未给予药物治疗，或药物治疗方案不完整41.0
C3.9无指征用药6716.0
用法用量C4.1单次剂量过低17341.2
C4.2单次剂量过高102.4
C4.3给药频次过少6716.0
C4.4给药频次过多81.9
疗程C5.1疗程短41.0
医嘱/处方执行C6.1医嘱/处方开具或下发时人为的操作错误20.5
C6.10流程监管或制度管理相关（特殊使用药品、自备药、保管等）225.2
其他C8.3其他原因；详细说明51.2
合计420100.0
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住院患者新型口服抗凝药物相关问题调查与分析
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杨翠 , 宋奇修
中国新药与临床杂志 | 合理用药 2024,43(7): 551-555
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中国新药与临床杂志 | 合理用药 2024, 43(7): 551-555
住院患者新型口服抗凝药物相关问题调查与分析
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杨翠, 宋奇修
作者信息
  • 安徽医科大学第一附属医院/安徽省公共卫生临床中心 药学部，安徽 合肥　230012

    • 杨翠，女，主管药师，硕士，主要从事临床药学的研究，E-mail：

Investigation and analysis on drug-related problems of new oral anticoagulants in hospitalized patients
Cui YANG, Qi-xiu SONG
Affiliations
  • Department of Pharmacy, the First Affiliated Hospital of Anhui Medical University/Anhui Public Health Clinical Center, Hefei ANHUI 230012, China
出版时间: 2024-07-25 doi: 10.14109/j.cnki.xyylc.2024.07.13
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摘要
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目的

探讨住院患者新型口服抗凝药物（NOACs）的使用情况和临床应用药物相关问题（DRPs），为促进NOACs的合理使用提供参考。

方法

收集安徽医科大学第一附属医院2021年10月至2022年9月使用NOACs的住院患者病历共586份，依据相关指南、法规等对其进行回顾性点评，参考符合中国人群和医疗模式的《中国药物相关问题分类系统（V1.0）》使用标准对所发现的DRPs汇总分析。

结果

586份住院病历中，女性居多（52.4%），年龄为（69.5±12.6）岁，使用NOACs最常见的病因是非瓣膜性心房颤动（272例，46.4%），涉及3个品种、8个品规；其中358例患者发生了DRPs，累计发生389个DRPs，包括213个（54.8%）DRP1.1、72个（18.5%）DRP2.1、4个（1.0%）DRP3.1、65个（16.7%）DRP3.2和35个（9.0%）DRP3.3。

结论

本院NOACs的使用问题主要表现为单次剂量过低、给药频次过少及无指征用药。

新型口服抗凝药物  /  药物相关问题  /  心房颤动  /  用药审查  /  安全
AIM

To investigate the use of new oral anticoagulants (NOACs) and clinically relevant drug-related problems (DRPs) in hospitalized patients, in order to provide a reference for promoting the rational use of NOACs.

METHODS

A total of 586 medical records of inpatients using NOACs at the First Affiliated Hospital of Anhui Medical University from October 2021 to September 2022 were collected. Retrospective reviews were conducted according to relevant guidelines and regulations. The summary analysis of the observed DRPs was performed with reference to the criteria used in the Chinese Classification System for Drug-Related Problems (V1.0), which is adapted to the Chinese population and healthcare model.

RESULTS

Among the 586 cases, the majority were females (52.4%), and the average age was (69.5±12.6) years old. The most common indication for the use of NOACs was nonvalvular atrial fibrillation (272 cases, 46.4%), which involved three varieties and eight criteria. DRPs occurred in 358 patients, with a total of 389 DRPs identified, including 213 (54.8%) DRP1.1, 72 (18.5%) DRP2.1, 4 (1.0%) DRP3.1, 65 (16.7%) DRP3.2, and 35 (9.0%) DRP3.3.

CONCLUSION

The use of NOACs in our hospital are mainly manifested as low single doses, infrequent administration, and lack of indication for medication.

new oral anticoagulants  /  drug-related problems  /  atrial fibrillation  /  medication review  /  safety
杨翠, 宋奇修. 住院患者新型口服抗凝药物相关问题调查与分析. 中国新药与临床杂志, 2024 , 43 (7) : 551 -555 . DOI: 10.14109/j.cnki.xyylc.2024.07.13
Cui YANG, Qi-xiu SONG. Investigation and analysis on drug-related problems of new oral anticoagulants in hospitalized patients[J]. Chinese Journal of New Drugs and Clinical Remedies, 2024 , 43 (7) : 551 -555 . DOI: 10.14109/j.cnki.xyylc.2024.07.13
正文
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新型口服抗凝药物（new oral anticoagulants, NOACs）通过直接抑制凝血酶或凝血因子Ⅹa达到抗凝的作用。与传统的口服抗凝药华法林相比，NOACs的优点是采用固定剂量，起效快，与药物、食物相互作用少，安全性高，无需监测国际标准化比值（INR）等[1,2]。随着NOACs在临床广泛应用，可能会出现许多药物相关问题（drug-related problems, DRPs），影响抗凝效果。DRPs的概念于1970年由美国HEPLER和STRAND两位专家提出[3]，是指患者所经历的任何与药物相关或者可疑相关的、干扰预期治疗目的的非预期不良事件[4]。DRPs分类方法众多，如国际上常用Strand分类系统、Granada Ⅱ分类系统、PCNE分类系统等[5]。鉴于目前对DRPs的研究方法并未统一，本研究采用《中国药物相关问题分类系统（V1.0）》[6]对住院患者应用NOACs的DRPs进行分类、汇总和分析，为进一步规范本院NOACs临床合理应用提供一定的参考依据。
资料与方法
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资料来源
通过安徽医科大学第一附属医院信息管理系统（HIS），抽取2021年10月至2022年9月使用NOACs（包括利伐沙班、阿哌沙班、达比加群酯）的住院患者病历共586份进行回顾性分析，统计患者性别、年龄、住院天数、临床诊断、住院科室、体重指数（BMI）等一般资料。
评价方法
采用符合中国人群和医疗模式的DRPs研究方法《中国药物相关问题分类系统（V1.0）》使用标准[6]，结合药品说明书、《心房颤动：目前的认识和治疗建议（2021）》[7]、《中国创伤骨科患者围术期静脉血栓栓塞症预防指南（2021）》[8]、《常见静脉疾病诊治规范（2022）版》[9]、《中国急性血栓性疾病抗栓治疗共识》[10]等临床相关指南，统计586份住院病历中NOACs的使用病因、用法用量、药物相互作用、禁忌证、联合用药、不良反应的情况，完成治疗有效性（DRP1）、治疗安全性（DRP2）和其他（DRP3）以及原因类型（C）的分组汇总与分析。
统计学资料
采用Excel软件进行数据统计分析，计数资料以例（%）表示。
结果
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一般资料
586例使用NOACs的患者中，男性279例（47.6%），女性307例（52.4%）；年龄为（69.5±12.6）岁，其中年龄≤75岁的患者367例（62.6%），>75岁的患者219例（37.4%）；BMI<25 kg·m-2的患者377例（64.3%），≥25 kg·m-2的患者209例（35.7%）；住院天数<10 d的患者335例（57.2%），≥10 d的患者251例（42.8%）。
NOACs临床使用科室分布
NOACs临床使用分布在22个科室，前三位的科室分别是心血管内科211例（36.0%），骨科112例（19.1%），普外科64例（10.9%）。临床应用NOACs具体科室分布情况见表1。
使用NOACs的病因分布
使用NOACs最常见的病因是非瓣膜性心房颤动（NVAF）272例（46.4%），深静脉血栓108例（18.4%），髋关节置换42例（7.2%），膝关节置换40例（6.8%）；其次是肺栓塞23例（3.9%），动脉疾病12例（2.0%），肿瘤预防血栓8例（1.4%），心房、心室血栓6例（1.0%），瓣膜性心房颤动5例（0.9%），还有髂静脉综合征、膝关节韧带重建术、胫骨髁间棘骨折固定术等。
NOACs使用情况
586例患者使用的NOACs共涉及3个品种、8个品规。其中利伐沙班片369例（63.0%），包括拜尔医药和广东东阳光2个厂家，分别有2种规格，为10 mg和15 mg；阿哌沙班片117例（20.0%），包括常州恒邦和南京正大天晴2个厂家，规格为2.5 mg；达比加群酯胶囊100例（17.1%），包括上海勃林格和南京正大天晴2个厂家，规格为110 mg。
NOACs相关DRPs发生情况及原因
586例患者中共统计出389个DRPs，涉及358例（61.1%）患者，其中DRP1中药物治疗无效/不佳（DRP1.1）213个（54.8%），主要原因是单次剂量过低、给药频次过少；DRP2中可能发生药物不良反应事件（DRP2.1）72个（18.5%），主要原因有禁忌证、联合用药、不良反应；DRP3（DRP3.1、DRP3.2、DRP3.3）104个（26.7%），主要原因为无指征用药。具体DRPs见表2，DRPs的原因及分组见表3。
讨论
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本研究NOACs的使用主要集中在心血管内科和骨科，前者使用病因主要为NVAF，后者主要是深静脉血栓的预防和治疗。2022年《心房颤动：目前的认识和治疗建议（2021）》[7]指出，NOACs可作为心房颤动患者预防血栓栓塞抗凝治疗新选择，因其在保证抗凝疗效的同时明显减少出血的风险，常推荐使用的NOACs有利伐沙班、达比加群酯、阿哌沙班等。骨科通常是创伤性手术如人工全髋关节置换术、人工全膝关节置换术，可引起静脉损伤、静脉血流瘀滞及血液高凝状态，是导致静脉血栓栓塞（VTE）的高危因素。2021年《中国创伤骨科患者围手术期静脉血栓栓塞症预防指南》推荐需要进行药物预防VTE的发生可以选用NOACs，包括阿哌沙班和利伐沙班[8]。
本院586例住院患者中，使用利伐沙班的病例居首位，其次是阿哌沙班和达比加群酯，药物使用频率差异可能与患者的病因、医生的选择、患者的经济情况等有关。国外一项多中心、横断面研究分析住院患者使用NOACs的DRPs发生率，在纳入的人群中85.4%使用了利伐沙班[11]，与本研究结果相近。王声祥等[12,13]评价NOACs治疗NVAF成本-效用值和预防髋膝关节置换术后静脉血栓形成的成本-效果，结果表明达比加群酯在治疗NVAF期间更具有经济学优势，而利伐沙班在预防髋膝关节置换术后静脉血栓更具有经济学优势。COLLEEN等[14]比较利伐沙班与阿哌沙班治疗心房颤动患者的依从性，发现每日服用1次利伐沙班的患者具有更高的依从性和更少的治疗间隔；最近一项基于人群的队列研究结果发现接受阿哌沙班、利伐沙班和华法林的患者依从性相似，而接受达比加群酯的患者依从性较差[15]。故本院临床应用NOACs频率的差异可能与患者的经济情况及用药依从性有关。
目前国内大多数研究是针对单一NOACs，如王晓玲等[16]研究通过Granada-Ⅱ分类方法评价临床应用利伐沙班的DRPs，纳入247例患者中，71.7%发生了DRPs。在本研究的586例患者中，61.1%的患者发生了DRPs；采用《中国药物相关问题分类系统（V1.0）》对DRPs进行汇总分析，该使用标准充分汲取国外成熟DRPs分类系统的经验，同时结合国内医疗模式和药学监护形成的分类系统，更符合中国国情的研究方法。
有效性问题中以利伐沙班出现的DRP1.1居多（193例）。利伐沙班在某些特殊人群和不同的适应证中，其用量、给药频次可能有差异。对于心房颤动患者，指南和说明书推荐剂量为20 mg qd，低体重、高龄（>75岁）或肌酐清除率（CrCl）15~49 mL·min-1的患者推荐剂量为15 mg qd。本调查分析中112例患者给予利伐沙班的剂量多为15 mg qd，合并肾功能不全或高龄患者使用的剂量为10 mg qd或5 mg qd，多数心房颤动患者使用利伐沙班的剂量较说明书和指南推荐的剂量低。临床医生更多考虑患者的年龄、合并疾病、肾功能等情况，担心出血风险高，使用低剂量的利伐沙班。近年来有研究[17,18]表明在亚洲心房颤动患者中，使用10 mg qd的利伐沙班可降低估算肾小球滤过率（eGFR）<50 mL·min-1·1.73 m-2的患者发生大出血的风险，但eGFR≥50 mL·min-1·1.73 m-2的患者发生卒中的风险增加，且临床净效益较低。本研究中确有48例eGFR≥50 mL·min-1·1.73 m-2心房颤动患者使用低剂量利伐沙班。鉴于目前国内对低剂量利伐沙班的研究多为小样本研究，无法作为临床用药的依据，仍需要开展多中心、大样本研究来验证其临床获益。给药频次过少主要体现在利伐沙班用于治疗VTE时，说明书推荐治疗VTE的初始剂量是前3周15 mg bid，后续治疗的推荐剂量为20 mg qd，而在本调查中49例患者给药频次与说明书指南推荐不符。若剂量不足或给药频次过少，可能会增加发生血栓栓塞的风险。故建议临床医生根据说明书及指南采用正确的剂量、频次，对于出血风险高的患者加强用药监护。
本研究中发现安全性问题DRP2.1共72例，主要表现在禁忌证、联合药物不适宜、药品不良反应等。NOACs说明书中明确提到CrCl<30 mL·min-1的患者禁用达比加群酯，VTE的患者不推荐使用利伐沙班；CrCl<15 mL·min-1的NVAF患者避免使用利伐沙班。一项荟萃分析[19]发现尚无足够的证据证明NOACs使晚期肾功能不全或长期血透的患者获益。对于长期血透的心房颤动患者，利伐沙班和达比加群酯较阿哌沙班明显增加了患者的出血风险[20]。本研究中有15例肾功能不全患者存在禁忌使用NOACs的情况，建议临床医生使用NOACs之前评估患者的肾功能。联合用药不适宜亦会导致NOACs使用中出现用药安全性问题，如3例患者存在NOACs与低分子肝素联合用药禁忌，其中1例72岁女性患者，因NVAF使用低分子肝素钠注射液3 200 IU q12h，后更改为达比加群酯110 mg bid时未停用低分子肝素，两药联用导致增加出血风险。NOACs不良反应也是重点关注的DRPs，586份病历的病程记录中发现有6例药物不良反应，涉及药物均为利伐沙班，其中1例为严重不良反应，患者为87岁的女性，诊断为持续性心房颤动、心功能Ⅳ级、高血压2级（极高危）、肾功能不全，给予利伐沙班15 mg qd期间出现消化道出血，凝血功能异常，停用相关药物，予以禁食、抑酸护胃、口服凝血酶局部止血等对症处理后好转。尽管有研究[1]证实NOACs比华法林出血风险低，但仍有出血风险，建议临床明显活动性出血、具有大出血显著风险的病灶或病情、凝血异常、Child Pugh B和C级的肝硬化患者，需谨慎使用NOACs。
其他方面的问题主要涉及三个方面：（1）有未治疗的适应证（DRP3.1）。如4例有心房颤动患者未及时给予达比加群酯治疗，其中1例男性患者，81岁，诊断为持续性心房颤动、心功能Ⅱ~Ⅲ级、高血压2级（极高危），该患者CHA2DS2-VASc评分4分，住院期间未用抗凝药物，出院后服用达比加群酯。为避免DRPs的发生，建议临床医师首先对心房颤动患者进行栓塞风险评估，若有使用抗凝药物指征、无禁忌证，应及时给予NOACs。（2）无指征用药（DRP3.2）。NOACs用于心室、心房血栓、动脉硬化闭塞瓣膜性心房颤动（重度二尖瓣狭窄）等属于无指征用药。虽然有研究[21,22]提示NOACs对左心室血栓有效，但需要大型的随机对照研究进一步证实；另外阿哌沙班国内说明书只批准用于髋关节及膝关节置换后VTE的预防，对于本研究中22例其他骨科手术患者使用阿哌沙班并无充分循证医学证据支持。（3）不确定的问题（DRP3.3）。有35例（9.0%）患者使用NOACs出现DRPs无法明确进行分类，最常见原因是自备药管理流程及制度问题。因此医院需加强NOACs作为自备药的管理流程并制定完善的自备药管理制度。
本研究也存在不足之处，通过回顾性点评分析DRPs发生情况，无法及时对临床应用NOACs发生DRPs进行干预，在后续的工作中，我们将结合此次调查结果，运用此标准从医师、护理、患者、药物四个层面对药学监护过程中发现的DRPs进行分类解析，为中国药师开展标准化的药学监护工作提供一定参考依据。
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参考文献 引证文献
排序方式：
[1]
DAWWAS GK, DIETRICH E, CUKER A, et al. Effectiveness and safety of direct oral anticoagulants versus warfarin in patients with valvular atrial fibrillation: a population-based cohort Study [J]. Ann Intern Med, 2021, 174（7）: 910-919.
[2]
LUIGI DB. Use of direct oral anticoagulants in patients with atrial fifibrillation and valvular heart lesions [J]. J Am Heart Assoc,2016, 5（2）: e002776.
[3]
HEPLER CD, STRAND LM. Opportunities and responsibilities in pharmaceutical care [J]. Am J Hosp Pharm, 1990, 47（3）: 533-543.
[4]
李 达, 闫素英. 药物治疗管理教学与实践手册 [M]. 北京:人民卫生出版社, 2019: 26- 27.
[5]
谢升阳, 倪 阳, 王玮琴, 等. 药物相关问题分类系统的研究进展 [J]. 浙江医学, 2014, 36（4）: 345-348.
XIE SY, NI Y, WANG WQ, et al. Research progress in classification system of drug-related problems [J]. Zhejiang Med, 2014, 36（4）: 345-348.
[6]
廖 赟, 张 萍.《中国药物相关问题分类系统（V1.0）》使用标准 [J]. 中华预防医学杂志, 2022, 56（8）: 1042-1049.
LIAO Y, ZHANG P. Standard for the use of the Chinese classification system for drug-related problems [J]. Chin J Prev Med, 2022, 56（8）: 1042-1049.
[7]
黄从新, 张 澍, 华 伟. 心房颤动：目前的认识和治疗建议（2021）[J]. 中华心律失常学杂志, 2022, 26（1）: 15-88.
HUANG CX, ZHANG S, HUA W. Current knowledge and management of atrial fibrillation: consensus of Chinese experts 2021[J]. Chin J Cardiac Arrhyth, 2022, 26（1）: 15-88.
[8]
林庆荣, 杨明辉, 候志勇. 中国创伤骨科患者围术期静脉血栓栓塞症预防指南（2021） [J]. 中华创伤骨科杂志, 2021, 23（3）: 185-192.
LIN QR, YANG MH, HOU ZY. Guidelines for prevention of perioperative venous thromboembolism in Chinese orthopedic trauma patients （2021） [J]. Chin J Orthop Trauma,2021, 23（3）: 185-192.
[9]
吴丹明. 常见静脉疾病诊治规范（2022年版）[J]. 中华血管外科杂志, 2022, 7（1）: 12-29.
WU DM. Diagnostic and therapeutic norms for common venous diseases （2022 edition） [J]. Chin J Vasc Surg, 2022, 7（1）: 12-29.
[10]
马青变, 郑亚安, 朱继红, 等. 中国急性血栓性疾病抗栓治疗共识 [J]. 中国急救医学, 2019, 39（6）: 501-532.
MA QB, ZHENG YA, ZHU JH, et al. Consensus on antithrombotic treatment of acute thrombotic diseases in China [J]. Chin J Crit Care, 2019,39（6）: 501-532.
[11]
VIPREY M, JEANNIN R, PIRIOU V, et al. Prevalence of drug-related problems associated with direct oral anticoagulants in hospitalized patients: a multicenter, cross-sectional study [J]. J Clin Pharm Ther, 2017, 42（1）: 58-63.
[12]
王声祥, 任艳平, 李 楠, 等. 新型口服抗凝药治疗非瓣膜病房颤的成本-效用分析 [J]. 中国药师, 2020, 23（10）:1971-2029.
WANG SX, REN YP, LI N, et al. Cost-utility analysis of novel oral anticoagulants in the treatment of non-valvular atrial fibrillation [J]. China Pharmacist, 2020, 23（10）: 1971-2029.
[13]
王声祥, 任艳平, 李 楠, 等. 阿哌沙班、利伐沙班、达比加群酯、依诺肝素预防髋膝关节置换术后静脉血栓形成的成本-效果分析 [J]. 中国医院药学杂志, 2020, 40（2）: 208-212.
WANG SX, REN YP, LI N, et al. Cost-effectiveness evaluation of apixaban rivaroxaban dabigartan in the prevention of venous thromboembolism after total hip and knee arthropalsty [J]. Chin J Hosp Pharm, 2020, 40（2）: 208-212.
[14]
MCHORNEY CA, PETERSON ED, LALIBERTE F, et al. Comparison of adherence to rivaroxaban versus apixaban among patients with atrial fibrillation [J]. Clin Ther, 2016, 38（11）:2477-2488.
[15]
ARNAR BI, JOHANN PH, SIGRUN HL, et al. Comparison of medication adherence to different oral anticoagulants: population-based cohort study [J]. BMJ Open, 2023, 13（1）: e065700.
[16]
王晓玲, 李晓慧, 梁 海, 等. 基于Granada-Ⅱ分类法对临床应用利伐沙班药物相关问题的评价[J]. 中华全科医学,2022, 20（9）: 1608- 1611.
WANG XL, LI XH, LANG H, et al. Evaluation of drug-related problems in clinical application of rivaroxaban based on Granada-Ⅱ classification[J]. Chin Gen Prac, 2022, 20（9）: 1608- 1611.
[17]
CHAN YH, LEE HF, WANG CL, et al. Comparisons of rivaroxaban following different dosage criteria （ROCKET AF or J-ROCKET AF Trials） in Asian patients with atrial fibrillation [J]. J Am Heart Assoc, 2019, 8（21）: e013053.
[18]
CHENG WH, CHAO TF, LIN YJ, et al. Low-dose rivaroxaban and risks of adverse events in patients with atrial fibrillation [J]. Stroke, 2019, 50（9）: 2574-2577.
[19]
HA JT, NEUEN BL, CHENG LP, et al. Benefits and harms of oral anticoagulant therapy in chronic kidney disease [J]. Ann Intern Med, 2019, 171（3）: 181-189.
[20]
KUNO T, TAKAGI H, ANDO T, et al. Oral anticoagulation for patients with atrial fibrillation on long-term dialysis [J]. J Am Coll Cardiol, 2020, 75（3）: 273-285.
[21]
HERALD J, GOITIA J, DUAN L, et al. Safety and effectiveness of direct oral anticoagulants versus warfarin for treating left ventricular thrombus [J]. Am J Cardiovasc Drugs, 2022, 22（4）: 437-444.
[22]
BASS ME, KISER TH, PAGE RL 2nd, et al. Comparative effectiveness of direct oral anticoagulants and warfarin for the treatment of left ventricular thrombus [J]. J Thromb Thrombolysis,2021, 52（2）: 517-522.
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doi: 10.14109/j.cnki.xyylc.2024.07.13
  • 接收时间：2023-02-24
  • 首发时间：2026-03-13
  • 出版时间：2024-07-25
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  • 收稿日期：2023-02-24
  • 录用日期：2024-04-25
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    安徽医科大学第一附属医院/安徽省公共卫生临床中心 药学部，安徽 合肥　230012
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