基于属性层次模型法评价非甾体类抗炎药在癌症疼痛药物治疗中临床应用情况  

Evaluation of clinical application of non-steroidal anti-inflammatory drugs in the medication of cancer pain based on the attribute hierarchy model

作　　者：宋佳伟 王媛媛[2] 陈慧娟[1] 刘丽 赵欢欢 孟冰冰 张鹏程 张红 SONG Jiawei;WANG Yuanyuan;CHEN Huijuan;LIU Li;ZHAO Huanhuan;MENG Bingbing;ZHANG Pengcheng;ZHANG Hong(Clinical Pharmacy Center,the People’s Hospital of Bozhou,Anhui Bozhou 236800,China;School of Medicine,Bozhou Vocational and Technical College,Anhui Bozhou 236800,China)

机构地区：[1]亳州市人民医院临床药学中心,安徽亳州236800 [2]亳州职业技术学院医学院,安徽亳州236800

出　　处：《中国医院药学杂志》2025年第5期595-600,共6页Chinese Journal of Hospital Pharmacy

基　　金：安徽省教育厅高校科研重点项目(编号:2023AH053215);国家卫生健康委医院管理研究所科研重点项目(编号:YLZLXZ24K012)。

摘　　要：目的:基于属性层次模型法综合评价非甾体类抗炎药(NSAIDs)在癌症疼痛药物治疗中临床应用情况。方法:以药品说明书、诊疗规范和专家共识为依据,建立亳州市人民医院NSAIDs的药物利用评价标准。采用回顾性研究方法,基于属性层次模型法对该院2023年887份使用NSAIDs的癌症疼痛病例进行综合评价。结果:该院NSAIDs在癌症疼痛药物治疗中存在的主要问题为未遵循癌症疼痛药物治疗基本原则(640例,72.15%)、无适应证用药(402例,45.32%)、联合用药不合理(288例,32.47%)、用法用量不适宜(199例,22.44%)、超疗程及限制日剂量(120例,13.53%)。病例得分平均为(76.98±9.23)分,其中≥90分的121例(13.64%),80~<90分的276例(31.12%),70~<80分的316例(35.63%),60~<70分的133例(14.99%),<60分的41例(4.62%)。NSAIDs人均费用为108.67元,占人均总药品费用比例为2.02%。结论:该院NSAIDs在癌症疼痛药物治疗中存在问题较为集中,需加强监管,促进合理用药,特别是NSAIDs注射液使用过于广泛、NSAIDs联合用药以及未严格遵守癌症疼痛药物治疗基本原则的问题。OBJECTIVE To comprehensively evaluate the clinical application of non-steroidal anti-inflammatory drugs(NSAIDs)in the medication of cancer pain using the attribute hierarchy model.METHODS The drug use evaluation standards of NSAIDs in the People’s Hospital of Bozhou were established on the basis of drug instructions,diagnostic and treatment stan⁃dards,and expert consensus.A retrospective study was conducted base on the attribute hierarchy model to comprehensively evalu⁃ate 887 cases of cancer pain medicated with NSAIDs in our hospital in 2023.RESULTS The main problems with the use of NSAIDs in the treatment of cancer pain in the hospital were failure to follow the basic principles of cancer pain medications(640 cases,72.15%),off-label indications(402 cases,45.32%),unreasonable combination therapy(288 cases,32.47%),inappro⁃priate usage and dosage(199 cases,22.44%),and exceeding the treatment course and limited daily dose(120 cases,13.53%).The average medical record score was 76.98±9.23,with≥90 scores achieved in 121 cases(13.64%),80-<90 scores in 276 cases(31.12%),70-<80 scores in 316 cases(35.63%),60-<70 scores in 133 cases(14.99%)and<60 scores in 41 cases(4.62%).The per capita cost of NSAIDs was 108.67 yuan,accounting for 2.02%of the total per capita drug cost.CONCLUSION The use of NSAIDs in the treatment of cancer pain has a concentrated issue in our hospital.The supervision to promote rational drug use,especially the widespread use of NSAIDs injections,NSAIDs combination medication and the failure to strictly adhere to the basic principles of cancer pain medication should be strengthened.

关 键 词：非甾体类抗炎药 属性层次模型 药物利用评价 癌症疼痛 

分 类 号：R979.1[医药卫生—药品]