基于加权TOPSIS法的卡前列素氨丁三醇药物利用评价

Drug utilization review of carboprost tromethamine based upon weighted TOPSIS method

目的:建立卡前列素氨丁三醇合理使用评价细则,为临床合理使用该药提供参考。方法:以卡前列素氨丁三醇的说明书为基础,参考有关指南和文献,通过专家咨询法,制定药物的合理性评价细则,采用基于层次属性模型的加权TOPSIS法对福建省妇幼保健院2022年度563例产科住院患者使用该药的情况进行评价。结果:根据加权TOPSIS法评价的结果,563份病例中,143例(占25.40%)用药合理,376例(占66.79%)用药基本合理,44例(占7.82%)用药不合理。不合理用药主要表现在适应证、禁忌证、药物慎用情况、给药时机、药物相互作用等方面,其中适应证、给药方式、给药时机方面存在超说明书用药现象。结论:基于加权TOPSIS法的卡前列素氨丁三醇药物利用评价方法可用于该药的利用评价,评价结果显示,该药使用基本合理,但仍存在不合理使用现象,需加强管理,进一步规范该药的合理使用。

OBJECTIVE To establish reasonable evaluation criteria for rational use of carboprost tromethamine(CT)and provide references for its rational application in clinical practices.METHODS Based upon the package insert for CT along with the relevant guidelines and literature,a set of criteria were formulated for evaluating its rationality through expert consultations.Using the weighted TOPSIS method of hierarchical attribute model,the usages of CT for 563 patients were evaluated at Fujian Maternity&Children’s Health Hospital in 2022.RESULTS Among them,143 cases(25.40%)were judged as rational,376 cases(66.79%)basically rational and 44 cases(7.82%)irrational.Irrational use was mostly caused by inappropriate indications,contraindications,cautious uses,dosing timing and drug interactions.And there were instances of off-label use in indications,dos⁃ing route and timing.CONCLUSION Weighted TOPSIS method may be employed for evaluating the use of CT.And CT has been prescribed basically rationally.However,instances of irrational use require strengthened management.