基于属性层次模型联合逼近理想解排序法的依降钙素注射液临床合理用药评价标准的建立与应用

Establishment and application of evaluation criteria for clinical rational use of Elcatonin injection based on AHM-TOPSIS method

目的建立依降钙素注射液药物利用评价细则,探讨属性层次模型(AHM)联合逼近理想解排序(TOPSIS)法在依降钙素注射液药物利用合理性评价中的应用。方法制定依降钙素注射液药物利用评价标准,采用AHM确定各指标权重,利用TOPSIS法对杭州市萧山区中医院156例使用依降钙素注射液患者的用药合理性进行评价,根据评价结果制定相应的干预措施,实施措施并对干预后使用情况进行评价。结果干预前156份病历中,根据评价标准用药基本合理为73份(46.8%),不合理的83份(53.2%)。疾病诊断、给药剂量、给药频率、特殊人群、症状及体征、辅助检查和实验室检查、病程记录等是导致依降钙素注射液用药不合理的主要因素。干预后108份病历中基本合理为96份(88.9%),不合理的12份(11.1%),与干预前用药合理情况明显改善。结论通过AHM-TOPSIS建立了依降钙素注射液临床应用合理性评价方法,所建立的方法切实可行,依降钙素注射液在本院的不合理使用较为普遍,应引起重视。

Objective To establish the detailed rules for evaluating drug utilization of Elcatonin injection and to explore the application of Attribute Hierarchical Model(AHM)and TOPSIS method in rationally evaluating the drug utilization of Elcatonin injection.Methods Establishing the review standard of the drug utilization of El-catonin injection.The weight of each index was determined by AHM.TOPSIS method was used to evaluate the rationality of the medication in 156 patients who had been treated with Elcatonin injection in Xiaoshan District Hospital of Traditional Chinese medicine(hereinafter referred to as“Our hospital”).According to the evaluation results,the corresponding intervention measures were formulated and implemented.Then the application after intervention was evaluated.Results Among the 156 cases before intervention,73 cases(46.8%)were basically rea-sonable and 83 cases(53.2%)were unreasonable according to the evaluation criteria.The main problems of Elcatonin injection use were disease diagnosis,dosage,frequency of administration,special population,symptoms and signs,auxiliary examination,and laboratory examination,etc.Among the 108 medical records after intervention,96 were basically reasonable(88.9%),while 12 were unreasonable(11.1%),indicating a significant improvement in medication rationality compared to the medication before intervention.Conclusion The method established by AHM-TOPSIS to evaluate the clinical rationality of the application of Elcatonin injection is feasible.The unrea-sonable application of Elcatonin injection in our hospital is more common,which should be paid great attention to.