基于属性层次模型的人促红素注射液合理性评价
Evaluation on rationality of recombinant human erythropoietin injection based on attribute hierarchy model
岳云月 1狄潘潘 1夏茹楠 1李帅 1王志远 1贾淑云 1梁海1
作者信息
- 1. 安徽医科大学附属亳州医院 药学部,安徽 亳州 236800
- 折叠
摘要
目的 建立人促红素注射液(rhEPO)合理性评价体系,分析目前临床使用过程中存在的问题,为临床合理用药提供参考.方法 以 rhEPO 的说明书为基础,参考相关专家共识和指南制定用药合理性评价标准.根据入排标准随机抽取安徽医科大学附属亳州医院 2023 年 4 月—2024 年 4 月使用rhEPO的归档病历,应用属性层次模型(AHM)法对其进行合理性评价,并与传统点评方法进行一致性检验,确定AHM法的可行性.结果 372 份病历中,病历评分(MRS)≥90 分156例(占比 41.94%),75 分≤MRS＜90 分 55 例(占比 14.78%),60 分≤MRS＜75 分的 60 例(占比 16.13%),MRS＜60 分101 例(占比 27.15%);不合理类型主要表现为适应证 54 例次(占比 14.52%),用药或停药时机 151 例次(占比40.59%),用药剂量 179 例次(占比 48.12%)以及用药调整 163 例次(占比 43.82%)等.与传统点评方法比较,AHM法一致率为 90.59%(Kappa=0.785,P＜0.001).结论 基于AHM法建立的rhEPO评价体系切实可行,评价结果显示本院rhEPO使用存在不合理现象,医院需在适应证、用药或停药时机、用药剂量及用药调整等方面进一步规范、合理使用.
Abstract
Objective To establish the rational evaluation system of recombinant human erythropoietin injection(rhEPO),so as to identify problems existing in the current clinical use and provide references for its clinical application.Methods Based on the instructions of rhEPO,the rational evaluation criteria were formulated according to the relevant expert consensus and guidelines.According to the entry criteria,rhEPO in Bozhou Hospital Affiliated to Anhui Medical University from April 2023 to April 2024,and the attribute hierarchy model(AHM)method was applied to evaluate its rationality,and the consistency test with the traditional review method was conducted to determine the feasibility of AHM method.Results Among a total of 372 cases,MRS was≥90(n=156,41.94%),75≤MRS＜90(n=55,14.78%),60≤MRS＜75(n=60,16.13%),and MRS<60(n=101,27.15%).The unreasonable types were mainly manifested as 54 indications(14.52%),151 indications or withdrawal time(40.59%),179 indications(48.12%)and 163 medication adjustment(43.82%).Compared with the traditional review method,the AHM agreement rate was 90.59%(Kappa=0.785,P<0.001).Conclusion The rhEPO evaluation system based on AHM method is feasible,and the evaluation results show that the use of rhEPO in the hospital needs to further standardize and rationally use it in terms of indication,medication or withdrawal time,dosage and adjustment.
关键词
人促红素注射液/合理性评价/属性层次模型/一致性检验/适应证Key words
recombinant human erythropoietin/rationality evaluation/AHM/consistency check/indication引用本文复制引用
基金项目
安徽省重点研究与开发计划项目(2022e07020066)
出版年
2024
NETL
NSTL
万方数据