基于加权TOPSIS法的酚磺乙胺药物利用评价

Drug use evaluation of etamsylate based on weighted TOPSIS method

目的建立酚磺乙胺药物利用评价标准,并采用加权优劣解距离(TOPSIS)法对酚磺乙胺的使用情况进行评价,为促进其临床合理用药提供依据。方法以注射用酚磺乙胺说明书为基础,参照国内外止血相关指南、循证文献,并通过专家咨询法,建立酚磺乙胺药物利用评价标准细则,采用基于属性层次模型的加权TOPSIS法对北京北亚骨科医院2022年3—6月使用酚磺乙胺的住院患者病历进行用药合理性评价。结果共纳入119份病历,用药方案与最优方案接近程度(C_(i))≥0.8判定为合理,有2例(1.68%);0.6≤C_(i)<0.8为基本合理,有70例(58.82%);C_(i)<0.6为不合理,有47例(39.50%)。不合理率居前3位的是给药剂量及频次(66.39%)、配置方法(49.58%)、药物相互作用(24.37%)。结论基于加权TOPSIS法的酚磺乙胺药物利用评价方法可综合多个评价指标,可操作性强,评价方法简便灵活。该院酚磺乙胺使用合理率偏低,尤其在配置方法、给药剂量及频次、药物相互作用、疗程等方面存在问题,仍需加强管理。

Objective To establish drug use evaluation(DUE)standard of etamsylate and to evaluate the use of etamsylate by weighted superior and inferior solution distance(TOPSIS)method,so as to provide a basis for promoting its clinical rational use.Methods Based on the instructions of etamsylate for injection,the DUE criteria of etamsylate were established according to the relevant guidelines of hemostasis at home and abroad,evidence-based literature and expert consultation.The weighted TOPSIS method based on the attribute hierarchy model was used to evaluate the utilization of etamsylate in Beijing Beiya Orthopaedic Hospital.Results Among the 119 cases,2 cases(1.68%)were with the relative closeness degree between each case and the optimal regimen(C_(i))no less than 0.8,which was evaluated as reasonable;70 cases(58.82%)were with the C_(i)ranging between 0.8 and 0.6,which was evaluated as basically reasonable;47 cases(39.50%)were with the C_(i)less than 60%,which was evaluated as unreasonable.The top three unreasonable rates were dose and frequency(66.39%),configuration method(49.58%),and drug interaction(24.37%).Conclusion The method of DUE of etamsylate based on weighted TOPSIS method can synthesize several evaluation indexes,and the evaluation method is simple and flexible.The rational rate of use of etamsylate in this hospital is low,especially there are problems in configuration method,administration dose and frequency,drug interaction,treatment course and so on,and the management still needs to be strengthened.