摘要
目的建立质子泵抑制剂(PPIs)临床应用的评价方法,以促进PPIs的合理使用。方法以《质子泵抑制剂临床应用指导原则(2020版)》、相关药品说明书、临床指南、专家共识及文献为依据,专家共同商讨制订PPIs用药合理性评价标准。采用层次分析法(AHP)对评价标准的各项指标进行赋权,并运用加权逼近理想值排序法(TOPSIS)进行数据处理,评价用药合理性。随机抽取天津市北辰医院2024年1、4、7、10月共4个月份使用PPIs的患者1000例,采用AHP-TOPSIS法评价其用药合理性。结果建立的评价标准包括4个一级指标(用药指征、用法用量、注意事项、其他情况)与6个二级指标,二级指标中权重占比较高的有适应证、用法用量及重复给药(权重分别为0.501、0.157、0.157)。1000例中,相对接近程度系数Ci最高为1.000,最低为0.347。合理用药(Ci≥0.8)占比78.80%,基本合理用药(0.6≤Ci<0.8)占比8.80%,不合理用药(Ci<0.6)占比12.40%,且差异均有统计学意义(P<0.05)。结论应用AHP加权的TOPSIS法对使用PPIs的合理应用进行综合评价,可将多个指标结合起来对用药合理性进行量化评估,可使点评方式更加层次化、系统化,并且可操作性强、科学、结果可信,可为创建新的临床合理用药评价方法提供参考。
Objective To provide a methodological reference for scientifically evaluating the rational use of proton pump inhibitors(PPIs)in clinical practice.Methods Based on the Guidelines for the Clinical Application of Proton Pump Inhibitors(2020 Edition),relevant drug instructions,clinical guidelines,expert consensus,and literature,a set of criteria for evaluating the rational use of PPIs was developed through expert discussions.The Analytic Hierarchy Process(AHP)was used to assign weights to each indicator of the evaluation criteria,and the Technique for Order Preference by Similarity to Ideal Solution(TOPSIS)was used for data processing to evaluate the rationality of the medication use.A random sample of 1000 cases using PPIs from Tianjin Beichen Hospital in January,April,July,and October of 2024 was selected for evaluation using the AHP-TOPSIS method.Results The established evaluation criteria included four primary indicators(indication for use,dosage and administration,precautions,and other conditions)and six secondary indicators.Among the secondary indicators,the ones with the highest weights were indication for use,dosage and administration route of PPIs,and repeated administration(with weights of 0.501,0.157,and 0.157,respectively).In the 1000 cases,the highest closeness coefficient(Ci)was 1.000 and the lowest was 0.347.Rational medication use(Ci≥0.8)accounted for 78.80%,basically rational use(0.6≤Ci<0.8)accounted for 8.80%,and irrational use(Ci<0.6)accounted for 12.40%,with differences being statistically significant(P<0.05).Conclusions The AHP-weighted TOPSIS method provides a comprehensive evaluation of the rational application of PPIs,quantifying the rationality of drug use by integrating multiple indicators.This approach makes the evaluation more hierarchical,systematic,and operational,and the results are reliable.It serves as a valuable reference for developing new clinical rational medication evaluation methods.Irrational use of PPIs still exists in our hospital,and management should be strengthened in clinical applications.
作者
王萍
谢栋
WANG Ping;XIE Dong(Department of Pharmacy,Tianjin Beichen Hospital,Tianjin 300400,China;Department of Pharmacy,Tianjin Medical University General Hospital,Tianjin 300052,China)
出处
《医药导报》
北大核心
2026年第1期47-52,共6页
Herald of Medicine
基金
天津市北辰区卫健系统科技项目(SHGY-2024003)
北京生命绿洲公益服务中心研究项目(CPHCF TJYD-04280038)。
关键词
质子泵抑制剂
合理用药
处方点评
层次分析法
逼近理想值排序法
Proton pump inhibitors
Rational drug use
Prescription review
Analytic hierarchy process
Technique for order preference by similarity to an ideal solution
