基于德尔菲法构建基层医院碳青霉烯类抗菌药物合理使用评价指标

Construction of evaluation indicators for rational application of carbapenem antibiotics in primary hospitals based on Delphi method

目的基于德尔菲法构建基层医院碳青霉烯类抗菌药物合理使用评价指标, 旨在为基层医院碳青霉烯类药物的合理使用提供参考。方法以《碳青霉烯类抗菌药物临床应用评价细则》为骨架, 结合文献报道和基层医院特点, 制定基层医院碳青霉烯类抗菌药物合理使用评价指标专家函询问卷, 采用德尔菲法于2021年2—11月通过电子邮件的方式对15名行业内专家进行2轮问卷函询, 根据专家意见对指标进行调整, 并计算专家权威系数和协调系数。结果经过2轮专家函询, 构建了包含4个一级指标(适应证、品种选择、溶媒及配伍、超说明书用药), 30个二级指标的评价体系。2轮函询的专家积极系数均为100.00%(15/15), 专家平均权威系数为0.85。第2轮函询后, 指标重要性及可操作性的专家协调系数分别为0.217和0.269, 协调性检验均P <0.001。结论构建的基层医院碳青霉烯类药物合理使用评价指标具有较强的操作性及一定可信度, 可用于指导和规范基层医院碳青霉烯类药物的合理使用。

Objective To construct evaluation indicators for the rational use of carbapenem antibiotics in primary hospitals based on the Delphi method.Methods Based on the"Guidelines for clinical application evaluation of carbapenem antibiotics",combined with literature reports and characteristics of primary hospitals,an expert consultation questionnaire on evaluation indicators for the rational use of carbapenem antibiotics in primary hospitals was developed.By the Delphi method,a total of 15 experts were selected to conduct two rounds of questionnaire consultations through Email from February to November 2021.According to the expert suggestions,the items were modified,and the authority coefficient and coordination coefficients of experts were calculated.Results After two rounds of expert consultations,an evaluation system consisting of 4 primary indicators(indications,variety selection,solvents and compatibility,off-label drug use)and 30 secondary indicators was constructed.The positive coefficients of experts in two rounds of consultations were 100.00%(15/15),with an average authority coefficient of 0.85.After the second round of consultation,the expert coordination coefficients for the importance and feasibility of the indicators were 0.217 and 0.269,respectively,with a coordination test both P<0.001.Conclusions The evaluation indicators for rational application of carbapenem antibiotics in primary hospitals have strong operability and a certain level of reliability.They can be used to guide and standardize the rational application of carbapenem antibiotics in primary hospitals.