基于加权TOPSIS法的奥沙利铂评价标准的建立及用药合理性评价

Establishment of Oxaliplatin Evaluation Criteria Based on Weighted TOPSIS Method and Drug Rationality Evaluation

目的 构建基于加权TOPSIS法的奥沙利铂药物利用评价(drug utilization evaluation,DUE)标准,并对其应用的合理性及规范性进行探讨,为医嘱审核提供参考依据。方法 以奥沙利铂说明书为框架,结合相关标准及指南建立安徽医科大学附属宿州医院奥沙利铂DUE标准,并采用加权TOPSIS法对笔者所在医院2019年6月—12月共246份病历的奥沙利铂进行DUE,并根据评价结果进行分析、评价。结果 对11项评价指标进行属性层次模型分析,结果符合一致性检验,且11项对应的权重值分别是16.915%,9.950%,10.945%,5.970%,9.950%,13.930%,2.488%,8.955%,10.945%,3.483%,6.468%;246份病例中C_i最高为100%,最低为0,C_i≥80%有200例(81.30%),60%≤C_i<80%有24例(9.76%),C_i<60%有22例(8.94%);不合理用药主要集中在适应证、预处理方案、给药方法、剂量调整及给药顺序。结论 绝大部分患者的奥沙利铂用药符合说明书及相关指南或原则,仅极小部分患者出现不合理用药情况,建议依据奥沙利铂用药的原则或指南及说明书规范用药。基于加权TOPSIS法的奥沙利铂合理性评价结果直观,操作方便。

OBJECTIVE To construct a drug utilization evaluation(DUE)standard for oxaliplatin based on the weighted TOPSIS method,and to discuss the rationality and standardization of its application,so as to provide a reference for doctor’s order review.METHODS Based on the oxaliplatin instruction manual,combined with relevant standards and guidelines,the DUE standard of oxaliplatin in Suzhou Hospital Affiliated to Anhui Medical University was established.The weighted TOPSIS method was used to evaluate the oxaliplatin DUE of a total of 246 cases in hospital from June to December 2019,and analysis and evaluation according to the evaluation results.RESULTS The attribute hierarchical model analysis of 11 evaluation indicators was carried out,and the results conform to the consistency test,and the corresponding weight values of the 11 items were 16.915%,9.950%,10.945%,5.970%,9.950%,13.930%,2.488%,8.955%,10.945%,3.483%,6.468%;in the 246 cases,the highest Ci was 100%,the lowest was 0,200 cases(81.30%)with Ci≥80%,24 cases(9.76%)with Ci in the range of 60%to 80%,22 cases(8.94%)with Ci<60%;irrational drug use mainly focused on indications,conditioning regimen,administration method,dose adjustment and administration sequence.CONCLUSION Most of the patients’oxaliplatin medication complied with the instructions and relevant guidelines or principles,and only a very small number of patients have unreasonable drug use.For medication,it is recommended to standardize medication according to the principles or guidelines and instructions for oxaliplatin medication.The evaluation results of the rationality of oxaliplatin based on the weighted TOPSIS method are intuitive and easy to operate.