丙氨酰谷氨酰胺合理性评价标准的建立及应用

Establishment and application of rational evaluation criteria for alanyl glutamine

目的建立丙氨酰谷氨酰胺(Ala-Gln)合理性评价标准,评价本院Ala-Gln临床使用的合理性。方法以Ala-Gln药品说明书、专家推荐意见和治疗指南等为基础制定Ala-Gln评价标准,应用加权TOPSIS法对本院2018年7月至12月使用Ala-Gln的120份归档病历进行评价,作为药学干预前的基线。针对基线评价发现的问题进行药学干预,对2019年1月至6月使用Ala-Gln的120份归档病历进行再评价。结果2018年7月至12月用药合理率为15%(Ci≥0.6有18例)。经同步药学干预,2019年1月至6月用药合理率显著升高(52%,Ci≥0.6有62例,P<0.05),其中适应证、用法用量、溶媒、用药监护、禁忌证的不合理病例数均显著低于2018年7月至12月(P<0.01)。结论基于加权TOPSIS法制定的Ala-Gln合理性评价方法切实可行,本院Ala-Gln不合理使用现象较为严重,药学干预可以提高用药合理率。

AIM To establish the evaluation criteria on rational use of alanyl glutamine(Ala-Gln),and to provide reference for the evaluation of the rational use of Ala-Gln in clinical practice.METHODS On the basis of drug specification,expert recommendations,guidelines and other relevant documents,the evaluation criteria on rational use of Ala-Gln was developed.According to the criteria,the weighted TOPSIS was used to evaluate 120 cases of Ala-Gln in our hospital from July to December 2018 as the baseline before pharmaceutical intervention.Pharmaceutical intervention was conducted based on the results of the baseline evaluation,and 120 cases of archived medical records receiving Ala-Gln from January to June 2019 were re-evaluated.RESULTS Among the 120 cases from July to December 2018,the rational rate of medical records was only 15%(18 cases with Ci≥0.6).After synchronous pharmaceutical intervention,the rationality rate of medical records from January to June 2019 was significantly increased(52%,62 cases with Ci≥0.6,P<0.05),and the unreasonable number of medical records including indications,usage and dosage,solvent,medication monitoring and contraindications were significantly lower than those from July to December 2018(P<0.01).CONCLUSION The rational evaluation method of Ala-Gln based on weighted TOPSIS was feasible.The evaluation results showed that the irrational use of Ala-Gln was serious,and pharmacist intervention could improve the rational rate of drug use.