摘要
目的 建立注射用比伐芦定药物利用评价(DUE)标准,并采用加权优劣解距离(TOPSIS)法对其使用情况进行评价,为比伐芦定的合理用药提供参考依据.方法 基于国内外药品说明书、权威文献,通过德尔菲法制定注射用比伐芦定的DUE标准细则.采用加权TOPSIS法对山西白求恩医院2022年1-6月使用注射用比伐芦定的出院患者病历进行合理性评价.结果 纳入108份病历,用药方案与最优方案接近程度(Ci)≥ 0.8(合理)的 88 例(81.48％),0.6≤Ci＜0.8(基本合理)的 19 例(17.59％),Ci＜0.6(不合理)的1例(0.93％).标准细则中各评价指标不合理问题主要表现为给药剂量不适宜(12.04％)、不良反应处置不适宜(11.11％)、超禁忌证用药(3.70％)、超适应证用药(1.85％)、疗效监护不适宜(1.85％)、药物转换不适宜(1.85％)和不良反应监护不适宜(0.93％)等.结论 采用加权TOPSIS法评价注射用比伐芦定,结果更直观和全面.评价结果显示该院注射用比伐芦定在使用过程中存在一些不合理现象,需要在用法用量、不良反应处置、适应证和禁忌证等方面进一步规范注射用比伐芦定的使用.
Abstract
Objective To establish the drug use evaluation(DUE)standard of bivalirudin for injection,and to evaluate the use of the drug by weighted TOPSIS method,so as to provide a reference for rational use of bivalirudin.Methods Based on the package insert,clinical guidelines and consensus of experts of bivalirudin,the DUE standards were developed,and the weighted TOPSIS method was used to evaluate the rationality of the discharge medical records of Shanxi Bethune Hospital from January 1st to June 30th in 2022.Results Incorporating 108 medical records involving the use of bivalirudin for injection,88 cases(81.48％)exhibited a high degree of adherence(Ci≥0.8)between the prescribed drug regimens and the optimal recommendations,which is considered reasonable.Additionally,19 cases(17.59％)fell within the range of 0.6＜Ci＜0.8,indicating a generally reasonable adherence.Only one case(0.93％)had a Ci＜0.6,suggesting an unreasonable level of adherence.The irrational situations about various evaluation indicators in the DUE were mainly manifested in the inappropriate dosages of administration(12.04％),inappropriate disposal of adverse reactions(11.11％),using medicine with contraindications(3.70％),using medicine without indication(1.85％),inappropriate monitoring of adverse reactions(0.93％),etc.Conclusion The established DUE standards for bivalirudin are intuitive and comprehensive,and the evaluation results show that there are some unreasonable situations in the use of bivalirudin in the hospital,and it is necessary to standardize the use of bivalirudin in terms of dosages,disposal of adverse reactions,indication and contraindication.
维普
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