药物流行病学杂志2024,Vol.33Issue(6) :642-651.DOI:10.12173/j.issn.1005-0698.202312044

基于加权TOPSIS法评价阿替普酶治疗急性缺血性脑卒中的合理性

Rationality evaluation of alteplase in the treatment of acute ischemic stroke based on weighted TOPSIS method

郭思彤 蔡慧雅 苏恒海 张进华
药物流行病学杂志2024,Vol.33Issue(6) :642-651.DOI:10.12173/j.issn.1005-0698.202312044

基于加权TOPSIS法评价阿替普酶治疗急性缺血性脑卒中的合理性

Rationality evaluation of alteplase in the treatment of acute ischemic stroke based on weighted TOPSIS method

郭思彤 1蔡慧雅 2苏恒海 1张进华3
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作者信息

  • 1. 广西壮族自治区人民医院药学部(南宁 530000)
  • 2. 福建省漳州市第二医院药剂科(福建漳州 363199)
  • 3. 福建省妇幼保健院药剂科(福州 350001)
  • 折叠

摘要

目的 建立阿替普酶治疗急性缺血性脑卒中(AIS)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,为合理使用阿替普酶提供参考.方法 参照药品说明书和相关指南文献,结合专家咨询法制订阿替普酶治疗AIS的DUE标准,收集广西壮族自治区人民医院2020年1月—2022年6月使用注射用阿替普酶治疗AIS的住院患者病历,采用基于属性层次模型的加权TOPSIS法进行合理性点评.结果 共纳入126份病历,用药方案与最优方案的相对接近程度(Ci)>0.8(合理)的 80 例(63.49%),Ci介于 0.6~0.8(基本合理)的 40 例(31.75%),Ci<0.6(不合理)的6例(4.76%).不合理用药情况主要为禁忌证(32.54%)、给药剂量(7.14%)和药物转换(7.14%)等方面.结论 采用加权TOPSIS法评价阿替普酶治疗AIS的合理性,结果更直观和全面,该院阿替普酶的使用存在一定问题,需要在用药禁忌证、给药剂量等方面加强干预,促进临床合理使用阿替普酶.

Abstract

Objective To establish a drug use evaluation(DUE)criteria for alteplase in the treatment of acute ischemic stroke(AIS),and to evaluate the use of the drug by weighted TOPSIS method,to provide a reference for rational use of alteplase.Methods Based on the drug package insert,relevant guidelines,the DUE criteria for alteplase in the treatment of AIS were developed combined with expert consultation.The weighted TOPSIS method was used to evaluate the rationality of alteplase use in inpatients with AIS in the People's Hospital of Guangxi Zhuang Autonomous Region from January 2020 to June 2022,based on the attribute hierarchy model.Results A total of 126 medical records were included.Among them,80 cases(63.49%)exhibited a high degree of adherence(C,>0.8)between the prescribed drug regimens and the optimal recommendations,which was considered reasonable.Additionally,40 cases(31.75%)fell within the range of 0.6 ≤ Ci ≤ 0.8,indicating a basic reasonable adherence,and 6 cases(4.76%)had a C,<0.6,suggesting an unreasonable level of adherence.The irrational use of the drug mainly involved contraindications(32.54%),dosage(7.14%),and drug conversion(7.14%),among other aspects.Conclusion The weighted TOPSIS method is used to evaluate the rationality of alteplase in the treatment of acute ischemic stroke(AIS),and the results are intuitive and comprehensive.There are still problems in the use of alteplase in this hospital,and it is necessary to strengthen intervention to promote rational clinical use of alteplase in terms of contraindication of medication and dosage,etc.

关键词

阿替普酶/急性缺血性脑卒中/药物利用评价/加权优劣解距离法/合理用药

Key words

Alteplase/Acute ischemic stroke/Drug use evaluation/Weighted TOPSIS method/Rational drug use

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基金项目

广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210684)

出版年

2024
药物流行病学杂志
中国药学会 武汉医药(集团)股份有限公司

药物流行病学杂志

CSTPCD
影响因子:0.746
ISSN:1005-0698
参考文献量9
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