基于AHP-TOPSIS法和数据挖掘综合评价新型抑酸药伏诺拉生临床应用的合理性

Comprehensive evaluation of a new type of acid-suppressing drug vonoprazan based on AHP-TOPSIS method and data mining rationale for clinical use

目的建立伏诺拉生合理性使用评价标准,为临床合理用药提供参考依据。方法以伏诺拉生说明书、临床指南、专家共识为基础,制定伏诺拉生用药评价标准,采用层次分析法(AHP)对评价指标赋权,并通过逼近理想解排序法(TOPSIS法)对某院2021年1月1日至2022年1月31日期间的236例住院患者该药的使用进行合理性评价。构建logistic二元回归模型探讨不合理用药的影响因素,并通过OpenVigiL数据库挖掘该药上市后的不良反应。结果在236个病例中,合理病例71份(占比30.1%),基本合理病例1份(占比0.4%),不合理164份(占比69.5%)。Logistic回归分析发现合并使用抗血小板药物是导致预防用伏诺拉生增加的主因。此外共挖掘到该药的不良反应88种。结论AHP-TOPSIS法可用于伏诺拉生合理性评价,研究结果表明该药存在适应证不适宜、未进行经济学考量、未进行患者教育等不合理现象,同时还应关注该药的不良反应,加大管理力度,以促进临床合理用药。

Objective The evaluation criteria for the rational use of vonoprazan is established,in order to provide a reference for clinical rational drug use.Methods Based on the drug instructions of vonoprazan,clinical guidelines,and expert consensus,the evaluation standards for vonoprazan are formulated.AHP method was used to assign weights to various indexes of evaluation criteria.TOPSIS method was used to analyze the use of vonoprazan of 236 cases in the hospital from January 2021 to January 2022 and evaluate rational drug use.Logistic binary regression model was constructed to explore the influencing factors of irrational drug use,and through the OpenVigiL database to mine the adverse reactions of the drug after the market.Results Among 236 cases,there were 71 reasonable cases(30.1%),1 basic reasonable case(0.4%),and 164 unreasonable cases(69.5%).Logistic regression analysis found that concomitant use of antiplatelet drugs was the main reason for the increase in irrational drug use.In addition,a total of 88 adverse reactions of the drug were discovered.Conclusion The AHP-TOPSIS method can be used to evaluate the rationality of vonorasen.The research results show that the drug has unreasonable phenomena such as unsuitable indications,no economic considerations,and no patient education.At the same time,attention should also be paid to the adverse reactions of the drug.Intensify management efforts to promote clinical rational drug use.