基于加权TOPSIS法的人凝血酶原复合物的药物利用评价

Drug use evaluation of prothrombin complex concentrate based on weighted TOPSIS method

目的建立人凝血酶原复合物(PCC)药物利用评价(DUE)标准细则,利用加权优劣解距离(TOPSIS)法对PCC的使用情况进行评价,为其临床合理应用提供参考依据。方法以药品说明书为基础,参考相关资料,建立PCC的DUE标准细则,采用加权TOPSIS法对徐州医科大学附属医院2021年1—12月使用PCC的住院患者病历进行用药合理性评价。结果共纳入121份病历,三级指标中相对权重较大的依次为凝血功能、给药剂量、给药间隔、给药疗程、疾病诊断、病程记录和药物相互作用,其权重分别为0.0952,0.0913,0.0913,0.0913,0.0897,0.0841和0.0817。用药合理性评价:21例(17.36%)合理,39例(32.23%)基本合理,61例(50.41%)不合理。不合理用药主要表现在适应证、用法用量和药物相互作用3个方面。结论PCC的DUE标准细则综合多个评价指标,主次清晰,具有科学性和可操作性。PCC在适应证、给药剂量及药物相互作用方面存在不合理用药,应进行药学干预,促进其合理使用。

Objective To establish the detailed rules for the drug use evaluation(DUE)of prothrombin complex concentrate(PCC),and evaluate the use of PCC by weighted TOPSIS method to provide references for its clinical rational application.Methods Based on the instructions of PCC and referring to relevant data,the DUE standard rules were established,and weighted TOPSIS method was used to evaluate the rationality of medication in the cases of in patients who used PCC from January 2021 to December 2021 in the Affiliated Hospital of Xuzhou Medical University.Results A total of 121 cases were included,the relative weights of the three indicators were as follows:coagulation function,dosage,interval,course of treatment and,diagnosis,progress notes drug interaction,with the weights of 0.0952,0.0913,0.0913,0.0913,0.0897,0.0841 and 0.0817 respectively.There were 21 cases(17.36%)with reasonable medical records,39 cases(32.23%)with basically reasonable medical records,and 61 cases(50.41%)with unreasonable medical records.The main unreasonable problems were manifested in indications,usage and dosage,and drug interaction.Conclusion The DUE criteria of PCC established is more scientific,practical and feasible.The indications,usage,dosage,and drug interaction of PCC remain unreasonable criteria,and pharmaceutical intervention should be carried out to promote its rational use.