西安交通大学：《药事管理学进展》研究生课程教学课件（PPT讲稿）第4章 药物利用研究 第1节 药物利用研究概述

西安交通大学XIANJIAOTONGUNIVERSITY药物利用研究第一节药物利用研究概述西安交大药学院药事管理与临床药学系2022年11月1896

药物利用研究 第一节 药物利用研究概述 西安交大药学院药事管理与临床药学系 2022年11月

CONTENS1.药物利用研究背景2.药物利用研究历史3.药物利用研究定义与范畴4.药物利用研究方法技能5.举例6.总结1896

CONTENS CONTENTS 1. 药物利用研究背景 2. 药物利用研究历史 3. 药物利用研究定义与范畴 4. 药物利用研究方法技能 5. 举例 6. 总结

StudyaimsDefinitionDrugutilizationresearchMain contentThe history of the development of drug utilization researchScientific disciplines related to drug utilization researchThe relationship, similarity and difference across drug utilizationpharmaco-epidemiology, and health service research.西安交大药学院药事管理与临床药学系

西安交大药学院药事管理与临床药学系 Definition • Drug utilization research Main content • The history of the development of drug utilization research • Scientific disciplines related to drug utilization research • The relationship, similarity and difference across drug utilization, pharmaco-epidemiology, and health service research. Study aims 3

1.药物利用研究背景1096AOTONGDrug Utilization Research:Background西安交大药学院药事管理与临床药学系

西安交大药学院药事管理与临床药学系 1. 药物利用研究背景 Drug Utilization Research: Background

1.Drug Utilization Research:BackgroundSomeBackground-WhyNeedfor Drug UtilizationResearch?西安交大药学院药事管理与临床药学系

西安交大药学院药事管理与临床药学系 Some Background —Why Need for Drug Utilization Research? 5 1. Drug Utilization Research: Background

C1.Drug Utilization Research:BackgroundThePositive SidesofDrugTherapyMedicinesplayan important rolein the provision of optimalcareand have a major impact on health.During the last decades of the 20th century, new medicineshavemarkedlydecreasedmortality,shortenedhospitalization duration and improved quality of lifeformillionsofpeople西安交大药学院药事管理与临床药学系

西安交大药学院药事管理与临床药学系 Medicines play an important role in the provision of optimal care and have a major impact on health. During the last decades of the 20th century, new medicines have markedly decreased mortality, shortened hospitalization duration and improved quality of life for millions of people. The Positive Sides of Drug Therapy 6 1. Drug Utilization Research: Background

1.Drug Utilization Research:Background25InfluenzaAged<1yearpandemic-Aged1-4years20oeMortality rateattributabletoeither15pneumonia orAntibioticsintroducedinfluenza among10children aged less than5years in the UnitedStates,1900-1960.501900192019401960Year西安交大药学院药事管理与临床药学系

西安交大药学院药事管理与临床药学系 Mortality rate attributable to either pneumonia or influenza among children aged less than 5 years in the United States, 1900–1960. 7 1. Drug Utilization Research: Background

81.DrugUtilizationResearch:BackgroundAnotherSideoftheSameStory20001600CrudeMortality RatesAllcauses(per1000001200Population)intheUnited StatesOverTime800Noninfectious causes400Infectiousdiseasecauses01920194019601980200020151900YearsHansenV,OrenE,DennisLK,BrownHE.InfectiousDiseaseMortalityTrendsintheUnitedStates,1980-2014.JAMA.2016;316(20):2149-2151doi:10.1001/jama.2016.12423西安交大药学院药事管理与临床药学系

西安交大药学院药事管理与临床药学系 Crude Mortality Rates (per 100 000 Population) in the United States Over Time Another Side of the Same Story Hansen V, Oren E, Dennis LK, Brown HE. Infectious Disease Mortality Trends in the United States, 1980-2014. JAMA. 2016;316(20):2149-2151. doi:10.1001/jama.2016.12423 8 1. Drug Utilization Research: Background

1.DrugUtilizationResearch:BackgroundTHELANCETARTICLESVOLUMEI,SSUE10036P1S6I-157E,MAY16,Z00SometimesRemdesivirinadultswithsevereCOviD.19:arandomised.doubie-blindplacebo-controlled,multicentretrial(formostofthetimes)Yeming Wang,Mn-DingyuZhang,MoProtGuanhuaDu,PhoProf RonghufDu,MDProfJiapingZhaoMDProfangJinMtalhowallauthasShowfootnothe positive effect10-RemdesivirControl0.9--eHazard ratio1-23 (95%C10-87-1-75);0.8log-rankp-0.240.70.6050-40-30-20-1012816202824Time since startofstudy (days)Numberat risk(numbercensored)123101826325158155147Remdesivirdvhutytaasimen(1)(0)(2)(0)(1)(0)(0)(26*)7878756452463817Controlir-5dbo-sdas(0)(0)(0)(0)(0)(0)(0)(16*)Timeto clinical improvementintheintention-to-treatpopulationAdjustedhazardratioforrandomisationstratificationwas1-25(95%CI0-88-1-78).*Including deaths before day 28 as right censored at day 28, thenumberofpatientswithoutclinical improvementwasstill included inthenumberatrisk.西安交大药学院药事管理与临床药学系

西安交大药学院药事管理与临床药学系 Sometimes (for most of the times), the positive effect could be modest Time to clinical improvement in the intention-to-treat population Adjusted hazard ratio for randomisation stratification was 1·25 (95% CI 0·88– 1·78). *Including deaths before day 28 as right censored at day 28, the number of patients without clinical improvement was still included in the number at risk. 9 1. Drug Utilization Research: Background

1.DrugUtilization Research:BackgroundTheNegativeSidesof DrugTherapyIt is also important to recognize the negative consequences of drugtherapyandthe emergingproblemof inappropriatedruguse.Increased morbidityand mortalityExcessivemedicalizationPolypharmacyAdverse drug reactions (ADRs)Antimicrobialresistance西安交大药学院药事管理与临床药学系

西安交大药学院药事管理与临床药学系 It is also important to recognize the negative consequences of drug therapy and the emerging problem of inappropriate drug use, • Increased morbidity and mortality • Excessive medicalization • Polypharmacy • Adverse drug reactions (ADRs) • Antimicrobial resistance The Negative Sides of Drug Therapy 10 1. Drug Utilization Research: Background