目的 了解我国儿科临床口服铁剂应用现状及存在问题,为儿童合理应用口服铁剂提供参考。方法 采用文本分析法和问卷调查法对全国25个省份、直辖市的48家儿童/妇幼医院口服铁剂儿科使用情况进行调研。结果 共收回有效问卷1002份。48家医院儿科共有22个口服铁剂品种,其中第3代口服铁剂应用最为广泛,剂型以溶液剂为主。在铁剂选择方面,多数医师主要考虑药品和患儿因素,22.54%的医师注重个人用药习惯。在用量方面,多数参研者主要参照药品说明书和本行业指南/共识,部分参研者依据成人用量换算(占30.04%)或经验用药(占23.35%)。超过20%的药师对用药疗程不太了解。85.52%的药师和98.17%的医师会进行用药注意事项的交代。77.25%的参研者会积极处理口服铁剂带来的不良反应,但对可采取的具体措施了解不够全面。超过40%的医师认为患儿用药依从性一般或较差,并认为其主要影响因素为铁剂的不良口味(82.34%)。结论 目前我国儿科临床应用的口服铁剂品种和剂型较为合理,但在应用过程中仍存在无据可依、医务人员认识不足及患儿用药依从性差等问题。相关部门和各医疗机构应予以重视并采取措施共同促进口服铁剂在儿科临床合理应用。

Objective To investigate the clinical situation and problems of oral iron supplements in pediatrics department of China and to provide reference for rational application of oral iron supplements in children.Methods Text analysis and questionnaire survey were used to investigate the pediatric application of oral iron supplements in 48 children's/maternity and children's hospitals in 25provinces and municipalities of China.Results A total of 1 002 valid questionnaires were collected. There were 22 oral iron supplements in 48 hospitals. Among them, the third generation and solutions were the most widely used. Most physicians prescribed oral iron supplements mainly considering the factors of drugs and children, and 22.54% of physicians would pay attention to their personal medication habits. The prescription dosage of oral iron supplements in pediatrics mainly referred to the usage and dosage labeling for children in the drug insert and the industry guidelines/consensus. The conversion of adult dosage according to the drug label and the empirical medication accounted for 30.04% and 23.35%, respectively. More than 20% of the pharmacists did not know much about the course of medication. 85.52% of pharmacists and 98.17% of physicians would explain the precautions for medication.77.25% of the participants would actively deal with the adverse reactions caused by oral iron supplements. However, there was insufficient understanding of specific measures that can be taken. More than 40% of the physicians thought that the medication compliance of children was general or poor. And the bad taste was considered to be the most important fact(82.34%).Conclusion At present, the varieties and dosage forms of oral iron supplements in pediatric clinical application are relatively reasonable. However,there are still problems such as unsubstantiated medication, insufficient awareness among medical staff and poor medication compliance of children. The relevant departments and medical institutions should pay attention and take measures to promote the rational use of oral iron supplements in pediatrics.

R973

福棠儿童医学发展研究中心药学专委会课题(FTSCR-2022-01)