基于AHP-TOPSIS法的围手术期预防使用质子泵抑制药合理性评价

Rationality Evaluation on Prophylactic Application of PPIs during Perioperative Period Based on AHP-TOPSIS

目的:为科学评价围手术期预防使用质子泵抑制药(PPIs)的合理应用提供方法参考。方法:以PPIs的说明书、临床指南、专家共识及相关参考文献为依据,由我院药事管理与药物治疗学委员会专家共同制定围手术期PPIs预防用药合理性评价标准,各项评价指标通过层次分析法(AHP)进行赋权,采用逼近理想解排序(TOPSIS)法进行数据处理,评价用药合理性。随机选取我院2020年15月围手术期预防使用PPIs的100个病例,采用AHP-TOPSIS法评价其用药合理性。结果:建立的评价标准包括4个一级指标与10个二级指标。100个病例中,相对接近程度系数Ci最高为1.0000,最低为0.4017。合理用药(Ci≥0.8)占比20.0%,基本合理用药(0.6≤Ci<0.8)占比41.0%,不合理用药(Ci<0.6)占比39.0%。结论:应用AHP加权的TOPSIS法对围手术期预防使用PPIs的合理应用进行综合评价,方法科学,结果可信,对创建新的临床合理用药评价方法具有一定的指导作用。

Objective:To provide method reference for scientifically evaluating the rationality of prophylactic application of proton pump inhibitors(PPIs)during perioperative period.Methods:Based on the drug instructions of PPIs,clinical guidelines,clinical pathways and related references,the experts in Pharmaceutical Affairs Management and Drug Therapy Committee of our hospital jointly discussed and formulated the evaluation criteria for the use rationality of PPIs during perioperative period.The AHP method was used to assign weights to various indexes of evaluation criteria.The TOPSIS method was used to process the data of the cases included in the study and evaluate the rationality of medication.Totally 100 cases of preventive use of PPIs were selected randomly during perioperative period from January 2020 to May 2020 in the hospital,and AHP-TOPSIS method was used to evaluate the rational drug application.Results:The evaluation criteria were established including 4 first-level indicators and 10 second-level indicators.The highest value of the relative proximity coefficient Ci was 1.0000,and the lowest was 0.4017 among the 100 cases.And 20.0%of drug use was reasonable,41.0%was basically reasonable and 39.0%was unreasonable.Conclusion:TOPSIS method weighted by AHP is used to comprehensively evaluate the reasonable application of PPIs for perioperative prevention.The method is scientific and the results are credible.It has a certain guiding effect on the establishment of new evaluation methods for clinical rational drug use.