西格列汀药物利用评价标准的建立与应用

Establishment of Drug Use Evaluation Criteria for Sitagliptin and Its Application

目的建立西格列汀药物利用评价(DUE)标准,采用属性层次模型(AHM)法综合评价西格列汀临床应用的合理性。方法以西格列汀药品说明书、相关指南或专家共识为依据,制订西格列汀DUE标准,包括用药前评估、适应证、遴选药品、用法用量、给药方式、禁忌证、联合用药、疗效评价、药品不良反应(ADR)、用药监护。采用AHM法评价医院2021年1月至12月165例应用西格列汀的归档病历。结果西格列汀不合理率从高到低排列前3位的分别为用药监护126例(76.36%)、用药前评估95例(57.58%)、遴选药品55例(33.33%)。病例评分(MRS)≥90分的38例(23.03%),70分≤MRS<90分的90例(54.55%),60分≤MRS<70分的24例(14.55%),MRS<60分的13例(7.88%)。结论该院西格列汀临床应用中存在较多不合理用药情况,需加强管控。基于AHM法的DUE操作简单,可计算出每份病历的具体分值,使评价结果更直观。

Objective To establish the drug use evaluation(DUE)criteria for sitagliptin,and to comprehensively evaluate the rationality of clinical application of sitagliptin by the attribute hierarchical model(AHM)method.Methods Based on the drug instructions,relevant guidelines or expert consensus of sitagliptin,the DUE criteria for sitagliptin was formulated,and the evaluation indexes included the pre-medication evaluation,indications,drug selection,usage and dosage,administration methods,contraindications,combination of drug use,efficacy evaluation,adverse drug reactions(ADR)and medication monitoring.The AHM method was used to evaluate the archived medical records of 165 cases using sitagliptin in the hospital from January 2021 to December 2021.Results Among the evaluation indexes of sitagliptin,the irrational rate of medication monitoring(126 cases,76.36%)was highest,followed by pre-medication evaluation(95 cases,57.58%)and drug selection(55 cases,33.33%).In terms of medical record score(MRS),MRS≥90 points,70 points≤MRS<90 points,60 points≤MRS<70 points and MRS<60 points accounted for 23.03%(38 cases),54.55%(90 cases),14.55%(24 cases)and 7.88%(13 cases),respectively.Conclusion There are many cases of irrational drug use in the clinical application of sitagliptin in this hospital,and it is necessary to strengthen its management and control.The DUE based on AHM method is simple,and the specific score of each medical record can be calculated,making the evaluation results more intuitive.