基于层次属性模型的术后用地佐辛注射液合理性评价

Rationality evaluation of postoperative use of Dizocine Injection based on hierarchical attribute model

目的 建立术后用地佐辛注射液合理性评价标准,分析其不合理用药情况,为临床合理、规范应用该药物提供参考依据。方法 参考药品说明书、专家共识和指南等制定术后用地佐辛注射液合理性评价细则,随机抽取安徽医科大学附属亳州医院2023年1~6月科室用药频度(DDDs)排名前5位的252例术后用地佐辛注射液的病历,应用属性层次模型(AHM)对其进行合理性评价。结果 252例病历中,病历评分(MRS)≥90分的优秀病历103例(占40.87%),75分≤MRS<90分的良好病历12例(占4.76%),60分≤MRS<75分的合格病历41例(占16.27%)以及MRS<60分的不合格病历96例(占38.10%)。不合理类型主要表现为无适应证48例次(占28.40%),用法用量43例次(占25.44%),用药疗程36例次(占21.30%),特殊人群用药22例次(占13.02%),联合用药10例次(占5.92%)及禁忌证5例次(2.96%)。结论 基于AHM法制定的术后用地佐辛注射液评价方法切实可行,评价结果显示安徽医科大学附属亳州医院术后用地佐辛注射液不合理用药情况较差,医院应进一步加强其医嘱点评、用药管理,提高临床用药合理性。

Objective To establish rational evaluation standard of postoperative use of Dizocine Injection,and the unreasonable drug use was analyzed to provide a reference for the rational clinical application of this drug.Methods To formulate the rational dosing evaluation system based on drug specification,expert recommendations,guidelines,and other relevant documents.The medical records of 252 patients with postoperative Dizocine Injection,who ranked the top 5 in department use frequency(DDDs)in Bozhou Hospital affiliated to Anhui Medical University from January to June 2023,were randomly selected,and the rationality of them was evaluated by attribute hierarchy model(AHM).Results Among the 252 medical records,103 excellent medical records(40.87%)had a medical record score(MRS)≥90,and 12 good medical records(4.76%)had a medical record score of 75≤MRS<90.There were 41qualified medical records(16.27%)with 60≤MRS<75 scores,and 96 unqualified medical records(38.10%)with MRS<60 scores.The irrational type mainly showed no indication 48 times(28.40%),usage and dosage 43 times(25.44%),treatment course 36 times(21.30%),special population 22 times(13.02%),combined use 10 times(5.92%)and contraindication 5 times(2.96%).Conclusion The evaluation method of Dizocine Injection for postoperative use formulated based on AHM method is feasible,and the evaluation results show that the situation of irrational use of Dizocine Injection for postoperative use in Bozhou Hospital affiliated to Anhui Medical University is poor.The hospital should further strengthen its medical order comments and medication management to improve the rationality of clinical use.