基于属性层次模型赋权法和加权TOPSIS法评价急诊儿科头孢地尼的用药合理性  

Evaluation of cefdinir drug utilization in emergency pediatrics based on weighted TOPSIS method

作　　者：钱自明 王猛 QIAN Ziming;WANG Meng(Department of Pharmacy,The First Affiliated Hospital of University of Science and Technology of China/Anhui Provincial Hospital,Hefei 230000,China)

机构地区：[1]中国科学技术大学附属第一医院-安徽省立医院药学部,合肥230000

出　　处：《中国临床药学杂志》2024年第4期259-263,共5页Chinese Journal of Clinical Pharmacy

摘　　要：目的基于属性层次模型(AHM)赋权法和加权TOPSIS法评价急诊儿科头孢地尼的用药合理性,为临床合理应用头孢地尼提供参考。方法以头孢地尼分散片说明书为基础,结合相关指南、专家共识及文献,建立头孢地尼药物利用评价(DUE)标准。通过AHM赋权法确立各评价指标的相对权重,采用加权TOPSIS法对2021年6月-2022年4月急诊儿科605份开具头孢地尼的处方进行评价。结果头孢地尼DUE标准中评价指标按相对权重排名,位列前三的分别为适应证(相对权重0.1073)、给药剂量和给药间隔(相对权重0.1064)和实验室检查(相对权重0.1025)。605份处方按头孢地尼DUE标准进行评价,各评价指标不合理率从高到低依次为实验室检查(78.68%)、适应证(28.26%)、替代药物(22.64%)、给药剂量和给药间隔(11.57%)、治疗结果(6.12%)、治疗时间(占5.12%)、处方医师权限(4.96%)、相互作用(4.79%)、给药途径(2.98%)、联合用药(1.16%)及特殊人群(0);利用加权TOPSIS法评价,用药合理(Ci≥80%)的有179份(占29.59%),用药基本合理(60%≤Ci<80%)的有301份(占49.75%),用药不合理(Ci<60%)的有54份(占8.93%)。结论头孢地尼用药情况基本合理,部分不合理用药情况体现在实验室检查不合理、适应证不合理和替代药物不合理方面,应继续细化并加强临床药师处方点评,进一步提高用药合理性。采用AHM赋权法和加权TOPSIS法对头孢地尼进行DUE,评价结果系统且直观,使用方便。AIM To evaluate the rationality of using cefdinir in emergency pediatrics based on the attribute hierarchy model(AHM)empowerment method and the weighted TOPSIS method,providing reference for the rational clinical application.METHODS Based on the instructions of cefdinir dispersed tablets,combined with guidelines,consensus and relevant literature,the criteria of cefdinir drug utilization evaluation(DUE)was established.The relative weight of each evaluation index was established by the AHM empowerment method.The weighted TOPSIS method was used to evaluate 605 prescriptions of cefdinir in emergency pediatrics from June 2021 to April 2022.RESULTS The top 3 weights in the secondary indexes of cefdinir DUE standard were indications(weight of 0.1073),dosage and dosing intervals(weight of 0.1064),and laboratory examination(weight of 0.1025).Cefdinir utilization evaluations scored each prescription on 11 indicators,with the following irrational result percentages:examination(78.68%),indications(28.26%),alternative medications(22.64%),dosage and dosing intervals(11.57%),treatment outcome(6.12%),route of administration(5.12%),prescription authorization(4.96%),interactions(4.79%),co-administration(1.16%),and special populations(0).There were 179 prescriptions with a compliance index(Ci)of 80%or higher among the 605 prescriptions,accounting for 29.59%.Additionally,there were 301 prescriptions with a Ci ranging from 60%to less than 80%,making up 49.75%.Furthermore,there were 54 prescriptions with a Ci below 60%,accounting for 8.93%.CONCLUSION While the use of cefdinir is generally reasonable,some instances of irrational medication use are evident,especially in unreasonable laboratory examination,unreasonable indications,and unreasonable alternative medications.The prescription review by clinical pharmacists should continue to be refined and strengthened to further improve the rationality of medication use.The DUE evaluation of cefdinir using the AHM empowerment method and the weighted TOPSIS method is systematic and intuitive,

关 键 词：头孢地尼 加权TOPSIS法 药物利用评价 用药合理性 

分 类 号：R969[医药卫生—药理学]