基于加权TOPSIS法对注射用奥美拉唑钠专项点评方法的建立与应用

Establishment and Application of Special Evaluation Method for Omeprazole Sodium for Injection Based on Weighted TOPSIS Method

关键词:  注射用奥美拉唑钠  加权优劣解距离法  专项点评方法

Key words:  omeprazole sodium for injection  technique for order of preference by similarity to ideal solution(TOPSIS)  special evaluation method

摘要:

目的 以药物利用评价(drug use evaluation，DUE)为基础，建立基于加权优劣解距离法(technique for order of preference by similarity to ideal solution，TOPSIS)的奥美拉唑静脉用药的合理性评价标准，为质子泵抑制剂专项点评提供参考。方法 根据国家指导原则、药品说明书、指南共识等，制定注射用奥美拉唑钠的合理性评价标准。随机调取2021年1—6月使用注射用奥美拉唑钠的病例作为对照组，7—12月的病例作为观察组。基于加权TOPSIS法计算各评价病例与正理想解的相对接近度(C_i)，C_i≥80%判断为用药合理，60%≤C_i＜80%判断为基本用药合理，C_i＜60%判断为用药不合理。运用χ²检验对观察组与对照组的合理率进行对比分析。结果 在对照组218例病例中，C_i≥80%的病例71例(32.57%)，60%≤C_i<80%的128例(58.71%)，C_i<60%的19例(8.72%)。观察组229例病例中，C_i≥80%的病例118例(51.53%)，60%≤C_i<80%的104例(45.41%)，C_i<60%的7例(3.06%)。观察组与对照组合理率相比，在适应证、给药剂量、给药疗程、药学监护及超医保限制用药方面，差异均具有统计学意义。结论 基于加权TOPSIS法所建立的注射用奥美拉唑钠的专项点评是合理且可行的，可降低点评人员的主观性评价，在加强医嘱点评力度、深度及实现标准化的专项点评方面可以提供参考。

Abstract:

OBJECTIVE To establish the criteria of evaluating the rationality of technique for order of preference by similarity to ideal solution(TOPSIS) intravenous omeprazole based on use drug use evaluation(DUE). And to provide reference guidance to the special evaluation of proton pump inhibitors. METHODS According to the national guidelines, drug instructions and consensus guidelines, the rationality evaluation criteria of omeprazole sodium for injection were formulated. Medical records of omeprazole sodium for injection from January to June 2021 were used as the control group, and medical records from July to December were used as the observation group. The relative proximity(C_i) between evaluated medical record and the rational solution was calculated by using TOPSIS method. If the C_i was ≥80%, categorized it as rational medication. If the C_i was <60%, categorized it as irrational medication. Any number between 80% and 60%, categorized it as nearly rational medication. χ² test was utilized to analyze the rate of rational medication between observational group and control group. RESULTS Among the 218 cases of control group, relative proximity(C_i) of 71 cases(32.57%) was ≥80%, that of 128 cases(58.71%) was 60%≤C_i<80%, and that of 19 cases(8.72%) was <60%. Among the 229 cases of observational group, C_i of 118 cases(51.53%) was ≥80%, that of 104 cases(45.41%) was 60%≤C_i<80%, and that of 7 cases(3.06%) <60%. Compared with the control group, the observation group had statistically significant differences in terms of indications, dosage, course of treatment, pharmaceutical monitoring and drug use beyond the medical insurance limit. CONCLUSION The special evaluation of omeprazole sodium for injection based on the weighted TOPSIS method is reasonable and feasible, which can reduce the subjective evaluation of the evaluation personnel, and can provide a reference for strengthening the strength and depth of the evaluation of medical orders and achieving standardized special evaluation.