基于AHM-TOPSIS法的奥赛利定临床合理用药评价标准的建立与应用

Establishment and application of evaluation criteria for clinical rational drug use of oliceridine based on AHM-TOPSIS method

关键词:  奥赛利定  属性层次模型  逼近理想值排序法  评价标准  合理用药

Key words:  oliceridine  attribute hierarchy model  technique for order preference by similarity to an ideal solution  evaluation criteria  rational drug use

摘要:

目的 基于属性层次模型（AHM）和逼近理想值排序（TOPSIS）法评价奥赛利定的临床用药合理性，为临床奥赛利定的合理使用和科学管理提供参考。方法 以富马酸奥赛利定注射液说明书为基础，结合相关指南、专家共识及文献，建立奥赛利定合理用药评价标准。通过AHM法确立各评价指标的相对权重，采用TOPSIS法对2024年10月-2025年9月全院开具的260份含奥赛利定的处方进行回顾性评价，根据相对接近程度（Ci）将评价结果分为用药合理、用药基本合理、用药不合理3个层次。结果 奥赛利定合理用药评价标准中评价指标按相对权重排名，位列前三的分别为适应证（权重为0.1635）、用法用量（权重为0.1472）和给药途径（权重为0.1361）。260份处方按奥赛利定合理用药评价标准进行评价，各评价指标不合理率从高到低依次为经济性、合并用药、用法用量、疗效评价、特殊人群、ADR处理和禁忌症；利用加权TOPSIS法评价，用药合理（Ci≥80%）的有55份，占21.15%；用药基本合理（60%≤Ci＜80%）的有11份，占4.23%；用药不合理（Ci＜60%）的有194份，占74.62%。结论 通过AHM-TOPSIS法建立了奥赛利定临床应用的合理性评价标准，该法所得评价结果可量化、科学可信。该药在本院的不合理使用现象较为普遍，临床应用时应加强管理。

Abstract:

OBJECTIVE To evaluate the clinical rationality of using oliceridine based on the attribute hierarchy model (AHM) and the technique for order preference by similarity to an ideal solution (TOPSIS) method, providing reference for the rational use and scientific management of oliceridine in clinical practice. METHODS Based on the instructions of oliceridine fumarate injection, combined with guidelines, consensus and relevant literature, the criteria of rational drug use evaluation for oliceridine was established. The relative weight of each evaluation index was established by the AHM method. The TOPSIS method was used to retrospectively evaluate 260 prescriptions of oliceridine from October 2024 to September 2025. The evaluation results were divided into three levels including reasonable, basic reasonable and unreasonable application based on the compliance index (Ci). RESULTS The top 3 weights in the secondary indexes of rational drug use evaluation for oliceridine were indications (weight of 0.1635), dosage and administration (weight 0.1472), and route of administration (weight 0.1361). Oliceridine utilization evaluations scored each prescription on 10 indicators, with the following irrational result percentages: economy, concomitant use, dosage and administration, efficacy evaluation, special populations, ADR treatment and contraindiction. There were 55 prescriptions with a compliance index (Ci) of 80% or higher among the 260 prescriptions, accounting for 21.15%. Additionally, there were 11 prescriptions with a Ci ranging from 60% to less than 80%, making up 4.23%. Furthermore, there were 194 prescriptions with a Ci below 60%, accounting for 74.62%. CONCLUSION The rationality evaluation criteria of oliceridine’s clinical application are established by AHM-TOPSIS method, and the evaluation results obtained by this method are quantifiable, scientific and reliable. The unreasonable use of oliceridine is common in our hospital, and the management should be strengthened in clinical application.