基于加权逼近理想解排序法的头孢他啶药物利用评价

Evaluation on Drug Utilization of Ceftazidime Based on Weighted TOPSIS Method

目的:建立头孢他啶药物评价标准,发现目前临床使用过程中存在的问题,为临床合理使用该药提供参考依据。方法:基于头孢他啶的药品说明书、临床指南或共识等,并结合文献制定头孢他啶药物评价细则。收集2021年7—12月某院使用头孢他啶治疗的归档病历120份,采用加权逼近理想解排序法(TOPSIS)进行药物利用评价。结果:二级指标中,疾病诊断相对权重排序居第1位,溶剂选择以及溶剂配置排序居最后2位。120份病历中,相对接近度(C_(i))>0.9的有22份(占18.33%),C_(i)>0.8~0.9的有17份(占14.17%),C_(i)>0.7~0.8的有45份(占37.50%),C_(i)>0.6~0.7的有25份(占20.83%),C_(i)≤0.6的有11份(占9.17%)。15个科室中,有12个科室的平均C_(i)处在良好区间(0.7~0.9),骨科、神经外科以及普外科的平均C_(i)偏低。某院头孢他啶的不合理使用主要集中在给药剂量方面。结论:采用加权TOPSIS法对头孢他啶应用合理性进行综合评价,可行性强,评价结果客观。通过对结果的分析,可以直观看到某院头孢他啶的使用大部分是合理的,但仍存在一些问题。某院可依据点评结果,进一步加强规范该药的合理使用。

OBJECTIVE:To establish the drug evaluation criteria of ceftazidime and find out the problems in current clinical application,so as to provide reference for clinical rational application.METHODS:According to the dispensatory,clinical guideline and consensus of ceftazidime,the evaluation rules of ceftazidine were formulated combined with relevant literature.Totally 120 archived medical records with ceftazidime treatment from Jul.to Dec.2021 were collected and evaluated for drug utilization by using the weighted TOPSIS method.RESULTS:Among the secondary indicators,the relative weight of disease diagnosis took the lead,and the solvent selection and solvent configuration ranked last.Among the 120 medical records,there were 22 medical records(18.33%)with C_(i)>0.9,17 medical records(14.17%)with C_(i)>0.8 to 0.9,45 medical records(37.50%)with C_(i)>0.7 to 0.8,25 medical records(20.83%)with C_(i)>0.6 to 0.7,and 11 medical records(9.17%)with C_(i)≤0.6.Of the 15 clinical departments,12 had mean C_(i) in the good range(from 0.7 to 0.9),while the orthopedics,neurosurgery,and general surgery departments had low mean C_(i).The irrational application of ceftazidime in the hospital was mainly focused on the dose administered.CONCLUSIONS:The comprehensive evaluation on the rationality of ceftazidime application by using the weighted TOPSIS method is feasible,and the evaluation results are objective.Through the analysis on the results,it can be intuitively seen that the application of ceftazidime in this hospital is mostly reasonable,but there are still some problems.Based on the results of the review,to further strengthen the regulation of rational drug application.