基于加权TOPSIS法的贝米肝素钠注射液药物利用评价  

Drug use evaluation of bemiparin sodium injection based on weighted TOPSIS method

作　　者：田璐璐[1] 李美娟 祝德秋[1] 蔡慧雅 张进华 TIAN Lulu;LI Meijuan;ZHU Deqiu;CAI Huiya;ZHANG Jinhua(Department of Pharmacy,Tongji Hospital,School of Medicine,Tongji University,Shanghai 200065,China;Department of Pharmacy,First Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Pharmacy,The Second Hospital of Zhangzhou,Zhangzhou 363199,Fujian Province,China;Department of Pharmacy,Fujian Maternity and Child Health Care Hospital,Fuzhou 350001,China)

机构地区：[1]同济大学附属同济医院药剂科,上海200065 [2]山西医科大学第一医院药剂科,太原030001 [3]漳州市第二医院药剂科,福建漳州363199 [4]福建省妇幼保健院药剂科,福州350001

出　　处：《药物流行病学杂志》2024年第5期481-488,共8页Chinese Journal of Pharmacoepidemiology

摘　　要：目的建立贝米肝素钠注射液药物利用评价(DUE)标准,并采用加权优劣解距离(TOPSIS)法对贝米肝素钠注射液的使用情况进行评价,为促进其合理使用提供参考。方法以药品说明书为基础,参考相关指南和文献,采用专家咨询法建立贝米肝素钠注射液的DUE标准细则,采用加权TOPSIS法对同济大学附属同济医院2021年6—7月使用贝米肝素钠注射液的住院患者病历进行合理性评价。结果在贝米肝素钠注射液DUE标准中,10个二级指标相对权重系数排名前2位的是禁忌证、不良反应处置,排名后2位的是给药方式、适应证。共纳入100份病历,用药方案与最优方案接近程度(C_(i))≥0.8(合理)的0例;0.6≤C_(i)<0.8(基本合理)的83例(83.00%);C_(i)<0.6(不合理)的17例(17.00%)。不合理用药主要表现在超适应证用药、超给药方式用药、存在潜在药物相互作用、给药剂量不适宜、违反用药禁忌证等方面。结论基于加权TOPSIS法的贝米肝素钠注射液DUE方法可综合多个评价指标,可操作性强,评价结果客观可信。该院贝米肝素钠注射液临床应用基本合理,需加快超说明书用药循证评价流程,加强管理力度,以保证临床合理用药。Objective To establish the drug use evaluation(DUE)criteria for bemiparin sodium injection,and evaluate the use of bemiparin sodium injection by weight technique for order prefer by similarity to ideal solution(TOPSIS),and to provide reference for improving the rational use of bemiparin sodium injection.Methods Based on the instructions of bemiparin sodium injection,and referring to relevant guidelines and literatures,the DUE criteria of bemiparin sodium injection was established by expert consultation.The weighted TOPSIS method was used to evaluate the rationality medication in the cases of inpatients who use bemiparin sodium injection from June to July 2021 in the Tongji Hospital of Tongji University.Results In the established DUE criteria of bemiparin sodium injection,the top two relative weight coefficients of ten secondary indicators were contraindications and adverse reaction disposal,and the bottom two were administration methods and indications.A total of 100 medical records were including.There was not a case close to the optimal regimen(C_(i)≥0.8)(reasonable);C_(i) was between 0.6 and 0.8(basically reasonable)in 83 cases(83.00%);and C_(i)<0.6(unreasonable)in 17 cases(17.00%).The unreasonable uses of bemiparin sodium injection mainly appeared in off-lable uses of indications and the dosing method,a potential drug-drug interaction,inappropriate dosage,and violation of drug contraindications.Conclusion The drug use evaluation method of bemiparin sodium injection based on weighted TOPSIS method can synthesize multiple evaluation indexes,and the evaluation results are objective and reliable.The results showed that most clinical application of bemiparin sodium injection in this hospital was basically reasonable,but to provide basis for rational clinical drug use and to ensure patients'medication safety,it is necessary to accelerate the off-label evidence-based evaluation process and strengthen the management of rational drug use.

关 键 词：贝米肝素钠注射液 加权优劣解距离法 药物利用评价 

分 类 号：R969[医药卫生—药理学]