基于德尔菲和层次分析法构建重点监控药品合理用药管理指标体系  

Constructing Index System for Rational Drug Use Management of Key Monitoring Drugs Based on Delphi Method and Analytic Hierarchy Process

作　　者：凌俐 司成 张海霞[4] 朱巧玲 葛卫红[1,4] 吴晓燕[4] LING Li;SI Cheng;ZHANG Haixia;ZHU Qiaoling;GE Weihong;WU Xiaoyan(Nanjing Drum Tower Hospital,Nanjing Drum Tower Clinical College,Nanjing Medical University,Nanjing 210008,China;School of Pharmacy,Nanjing Medical University,Nanjing 211166,China;Nanjing Drum Tower Hospital,Nanjing Drum Tower Hospital Clinical College,Nanjing University of Chinese Medicine,Nanjing 210008,China;Department of Pharmacy,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,China)

机构地区：[1]南京医科大学鼓楼临床医学院,南京210008 [2]南京医科大学药学院,南京211166 [3]南京中医药大学鼓楼临床医学院,南京210008 [4]南京大学医学院附属鼓楼医院药学部,南京210008

出　　处：《医药导报》2025年第3期503-508,共6页Herald of Medicine

基　　金：南京大学中国医院改革发展研究院课题(NDYGN2023001);南京市卫生科技发展专项(ZKX23020)。

摘　　要：目的构建重点监控药品合理用药管理指标体系,为医疗机构合理用药管理提供参考。方法通过调研重点监控药品相关政策法规、管理规范、指导原则等资料,确定初始指标框架,对26位专家进行2轮德尔菲函询,完善与优化指标体系,通过层次分析法(AHP)构建判断矩阵获得指标权重。结果2轮函询回收率均为100%,专家权威系数为0.87。最终构建的重点监控药品合理用药管理指标体系,涵盖事前管理(权重0.2536)、事中管理(权重0.5031)、事后管理(权重0.2432)3项一级指标;处方审核(权重0.3026)、制定合理用药规范(权重0.1331)、超常预警管理(权重0.1032)等15项二级指标;制定严格的处方审核规则(权重0.1525)、审方药师干预力度(权重0.0857)和有效性管理(权重0.0525)等62项三级指标,指标判断矩阵通过一致性检验。结论构建的重点监控药品合理用药管理指标体系可满足监督管理流程的闭环,做到事前提醒、事中监控、事后监管,为医疗机构保证管理流程精细化与规范化提供参考。Objective To construct an evaluation index system for rational drug use management of key monitoring drugs,and to provide references for medical institutions.Methods The preliminary index framework was formed by researching the policies and regulations,management norms,and guiding principles related to key monitoring drugs.Two rounds of Delphi questionnaire survey were conducted with 26 experts to improve and optimize the index system.The weights of the indicators were obtained by constructing the judgment matrix by analytic hierarchy process(AHP).Results The recovery rates of the two rounds of questionnaire were both 100%,and the authority coefficient was 0.87.The key monitoring drug rational use management evaluation index system was finally constructed to include three primary indicators[ex-ante management(0.2536),in-process management(0.5031),and ex-post management(0.2432)],15 secondary indicators[including prescription review(0.3026),formulate rational drug use norms(0.1331),supernormal early warning management(0.1032)],and 62 tertiary indicators[including formulate strict prescription review rules(0.1525),pharmacists prescription intervention strength(0.0857)and effectiveness management(0.0525)].and the index judgment matrix passed the consistency test.Conclusion The evaluation index system for the rational drug use management of key monitoring drugs constructed can satisfy the closed loop of the supervision and management process,achieve the prior reminder,monitoring,and post-supervision,and provide references for medical institutions to ensure the refinement and standardization of the management process.

关 键 词：重点监控药品管理 合理用药 指标体系 德尔菲法 层次分析法 

分 类 号：R95[医药卫生—药学]