目的:通过构建药物利用评价(drug use evaluation，DUE)标准并应用，提高甘草酸二铵注射液使用合理性。方法:以甘草酸二铵注射液说明书、肝功能不全相关指南、专家共识为依据建立DUE标准评价指标，采用属性层次模型(attribute hier-archy model，AHM)确定各指标的综合权重。临床药师按照甘草酸二铵注射液DUE标准具体内容对临床进行一系列合理应用干预，调取使用甘草酸二铵注射液的病历，将2022年1-12月共118例为干预前，2023年1-12月共171例为干预后，采用加权优劣解距离法(technique for order preference by similarity to an ideal solution，TOPSIS)分别统计干预前后两组病历与最优解的相对接近度(Ci)。结果:干预后在特殊人群、联合用药、给药后监护、不良反应处理合理性方面差异有统计学意义(P＜0。05);干预后90％≤Ci≤100％为合理的病历占比从12。71％提高至40。94％;60％≤Ci＜90％为基本合理的病历占比从78。81％下降至54。97％，差异均有统计学意义(P＜0。01)。结论:加权TOPSIS联合AHM构建甘草酸二铵注射液药物利用评价标准并于真实世界的应用，切实提高了其使用合理性，并为其他药品临床使用评价及管理提供参考。
Weighted TOPSIS plus attribute hierarchy model for constructing evaluation criteria for drug utilization of diammonium glycyrrhizinate injection and its real-world application
OBJECTIVE To improve the rational use of diammonium glycyrrhizinate injection through constructing and applying drug use evaluation(DUE)standards.METHODS DUE standard evaluation indicators were established based upon the instructions for d.glycyrrhizinate injection,liver dysfunction-related guidelines and expert consensus.Attribute hierarchy model(AHM)was employed for determining the comprehensive weights of each indicator.Clinical pharmacists conducted a series of reasonable application interventions in clinical practices according to the specific content of DUE standard for d.glycyrrhi-zinate injection.Medical records of using d.glycyrrhizinate injection were retrieved with a total of 118 cases from January to December 2022 as pre-intervention period and 171 cases from January to December 2023 as post-intervention period.Technique for Order Preference by Similarity to an Ideal Solution(TOPSIS)was utilized for calculating relative closeness between two groups of medical records and optimal solution before and after intervention separately.RESULTS After intervention,statisti-cally significant differences existed in special populations,combination therapy,post-dosing monitoring and rationality of adverse reaction management(P＜0.05);the proportion of reasonable medical records with 90％≤Ci≤100％after intervention spiked from 12.71％to 40.94％;the proportion of medical records with 60％≤Ci＜90％basically reasonable declined from 78.81％to 54.97％and the differences were statistically significant(P＜0.01).CONCLUSION Weighted TOPSIS plus AHM is utilized for constructing drug utilization evaluation standards for d.glycyrrhizinate injection and applied in real world.It effectively improves its rationality of use and provides references for clinical use evaluation and management of other drugs.
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