加权TOPSIS法评价人血白蛋白治疗肝硬化的合理性

Rationality evaluation of human albumin in the treatment of liver cirrhosis based on weighted TOPSIS method

目的基于加权逼近理想排序法(TOPSIS)建立人血白蛋白(HA)用于肝硬化治疗的药物利用评价标准,并对HA药物利用情况进行综合评价。方法以HA的说明书为基础,参照国内外相关肝硬化治疗指南和HA处方点评办法制定HA药物利用评价标准,利用加权TOPSIS法对2020年我院感染科诊断为肝硬化的住院患者使用HA的情况进行合理性评价。结果制定的HA药物利用评价标准包括基线检查、适应证、禁忌证、联合用药、用法用量等8个评价指标,并通过咨询专家设定了评分权重。评价我院1068份病历使用HA情况与最优方案和最劣方案的接近程度值(Ci),结果显示评价为合理病历(Ci≥0.8)有133份(12.45%),基本合理病历(0.6≤Ci<0.8)有576份(53.93%),不合理病历(Ci<0.6)有359份(33.61%)。主要的不合理问题为未进行基线检查、非适应证用药、禁忌证用药等。结论基于加权TOPSIS法制定的HA药物利用评价标准可以用于该药的合理使用评价。我院HA在肝硬化患者中的使用较合理,应继续加强管理,以减少或避免不合理用药情况。

OBJECTIVE To establish the drug use evaluation criteria of human albumin(HA)in the treatment of liver cirrhosis based on weighted technique for order preference by similarity to ideal solution(TOPSIS)method,and to comprehensively evaluate the utilization of HA.METHODS The drug use evaluation criteria of HA was established with reference to guidelines of liver cirrhosis treatment at home and abroad and HA prescription evaluation method,based on the HA instructions.The weighted TOPSIS method was used to evaluate the rationality of HA drug use in inpatients with liver cirrhosis diagnosed by the infection department of our hospital in 2020.RESULTS The established drug use evaluation criteria for HA included 8 evaluation indicators,i.e.baseline examination,indication,contraindication,combined use of drugs,usage and dosage,and so on;the scoring weight was set by consulting experts.According to the evaluation of the closeness degree(Ci)between the HA drug use of 1068 medical records and the optimal plan and the worst plan in our hospital,the result showed that 133(12.45%)were evaluated as reasonable medical records(Ci≥0.8),576(53.93%)as basically reasonable medical records(0.6≤Ci<0.8),and 359(33.61%)as unreasonable medical records(Ci<0.6).The main unreasonable problems were the absence of baseline examination,non-indication medication,medication for contraindication,etc.CONCLUSIONS The drug use evaluation criteria of HA based on the weighted TOPSIS method can be used to evaluate the rational use of the drug.The drug use of HA in patients with liver cirrhosis in our hospital is reasonable,and we should continue to strengthen the management to reduce or avoid unreasonable drug use.