摘要
目的建立重组人促红细胞生成素(rhEPO)注射液合理性评价体系,以发现目前临床使用过程中存在的问题,为临床合理用药提供参考。方法构建rhEPO合理性评价体系:①以rhEPO的说明书为基础,参考相关专家共识和指南制订用药合理性评价标准;②根据评价依据对上海市第一人民医院(南院)2023年1—6月使用rhEPO的住院患者进行各项指标的用药合理性评价;③采用属性层次模型(AHM)对指标层进行赋权,通过加权的优劣解距离法(TOPSIS)计算各病例与最优方案的相对接近度(C_(i)),得到用药合理性评价结果;④与传统点评方法进行一致性比较,确定AHM-TOPSIS法的可行性。结果572例病例中C_(i)≥0.8的有111例(19.4%),0.6≤C_(i)<0.8的有52例(9.1%),C_(i)<0.6的有409例(71.5%)。使用这种评价方法得到的结果与传统点评方法相比一致率为90.6%(Kappa=0.743,P<0.001)。结论基于AHM-TOPSIS法建立的rhEPO评价体系可以用于该药的合理性评价,评价结果提示,该院rhEPO的不合理使用现象较为普遍,应加强管理。
Objective To establish the evaluation criteria for rational application of recombinant human erythropoietin(rhEPO)injection and identify current problems and provide references for its clinical application.Methods Evaluation criteria were developed based on the rhEPO package insert,expert consensus,and guidelines.The criteria were used to evaluate the rationality of rhEPO use in inpatients at the South Branch of Shanghai General Hospital from January to June 2023.Attribute Hierarchy Model(AHM)was used to weight the evaluation indicators,and the Technique for Order Preference by Similarity to an Ideal Solution(TOPSIS)calculated each case's relative closeness(C_(i))to the optimal solution.The results were compared with traditional prescription review for consistency and feasibility assessment.Results Among the 572 case reports,111(19.4%)had C_(i)≥0.8,52(9.1%)had 0.6≤C_(i)<0.8,while 409(71.5%)had C_(i)<0.6.The AHM-TOPSIS method showed 90.6%consistency with the traditional review(Kappa=0.743,P<0.001).Conclusion The rhEPO evaluation criteria based on AHM-TOPSIS method can be used to evaluate the utilization of rhEPO,indicating common irrational use of rhEPO in the hospital.
作者
盛天枫
李琴
熊学惠
SHENG Tian-feng;LI Qin;XIONG Xue-hui(Department of Clinical Pharmacy,Shanghai General Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200080;Department of Pharmacy,Jinshan Zhongren Aged Care Hospital,Shanghai 201501)
出处
《中南药学》
CAS
2024年第10期2769-2774,共6页
Central South Pharmacy
基金
上海市松江区科技攻关项目(医药卫生类)(No.21SJKJGG159)。
