National treatment guidelines decreased the use of racemic adrenaline for bronchiolitis in four Finnish university hospitals
National treatment guidelines decreased the use of racemic adrenaline for bronchiolitis in four Finnish university hospitals
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DOI：
10.1111/apa.14397
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发表时间：
2018-11-01
期刊：
影响因子：
3.8
通讯作者：
Korppi, Matti
中科院分区：
文献类型：
--
作者：
Palmu, Sauli;Mecklin, Minna;Korppi, Matti
目的：在2014年新的国家毛细支气管炎现行护理指南出台之前，芬兰的许多医院都将吸入外消旋肾上腺素用于治疗毛细支气管炎，该指南将其推荐用于按需抢救治疗。我们研究了新指南出台前后的用药情况，以衡量处方习惯的变化。方法：本2012-2016年研究分析了四所大学医院急诊室、儿科病房和儿科重症监护室的儿童使用了多少剂量的0.5 mL外消旋肾上腺素，并估计了药物和人员成本。结果：细支气管炎指南发布前后两家医院的年消旋肾上腺素用量存在显著差异，药品成本和工作时间均有所减少。在研究期间，总体使用量减少了一半以上，特别是在基线消费量最高的两家医院，但在基线消费量已经很低的第三家医院没有。在第四组中，基线摄入量是适度的，在研究期间持续下降。结论：目前的毛细支气管炎护理指南对临床实践有一定的影响，因为外消旋肾上腺素的总体使用减少了一半以上，但在四家研究医院发表后仍存在相当大的差异。
Aim: Inhaled racemic adrenaline was used for bronchiolitis in many hospitals in Finland prior to new national current care guidelines for bronchiolitis in 2014, which limited its recommendations to on-demand rescue therapy. We studied the drug's use before and after the new guidelines to gauge changes in prescribing habits.Methods: This 2012-2016 study analysed how many 0.5 mL doses of racemic adrenaline were used for children by emergency rooms, paediatric wards and paediatric intensive care units at four university hospitals and estimated drug and staff costs.Results: There were substantial differences in the yearly consumption of racemic adrenaline between the hospitals before and after the bronchiolitis guidelines were published, with reductions in drug costs and staff time. The overall use more than halved during the study period, particularly in two hospitals where baseline consumptions were highest, but not in a third where baseline consumption was already low. In the fourth, the baseline consumption was modest and there was a constant decrease during the study years.Conclusion: The current care guidelines for bronchiolitis had some impact on clinical practice, as the overall use of racemic adrenaline more than halved, but considerable differences remained in the four study hospitals after their publication.