AHM联合TOPSIS法构建奥赛利定注射液药物利用评价标准及多中心真实世界应用

Construction of Drug Utilization Evaluation Criteria for Oliceridine Injection Using the AHM-TOPSIS Method and Its Application in a Multicenter Real-World Study

关键词:  药物利用评价  德尔菲法  属性层次模型法  优劣解距离法  奥赛利定  疼痛

Key words:  Drug utilization evaluation  Delphi method  AHM  TOPSIS  Oliceridine  pain

摘要:

目的 建立奥赛利定注射液的药物利用评价(drug utilization evalution, DUE)标准,评价和分析奥赛利定临床应用情况,为促进其临床合理使用提供参考。方法 以药品说明书、诊疗规范和专家共识为依据,采用德尔菲法建立奥赛利定的DUE标准,采用属性层次模型(attribute hierarchy model, AHM)确定各指标的综合权重。采用回顾性研究方法,基于优劣解距离法(technique for order preference by similarity to an ideal solution, TOPSIS)对2025年1月1日-2025年11月30日493例出院病历进行合理性评价。结果? 所建的DUE标准包括3个一级指标(用药指征、用药过程、用药结果)与11个二级指标(适应证、禁忌症、特殊人群等)。权重系数最高的二级指标是适应证(0.0833)与禁忌症(0.0833)。共纳入493份病历。根据加权TOPSIS法评价的结果,493份病历中,合理391份(79.3%)、基本合理102份(20.7%)。不合理的主要类型为特殊人群用药42份(8.5%)、超过日剂量限制与疗程32 份(6.5%)。结论? 奥赛利定临床应用基本合理,但仍需进一步规范该药的使用。建立的奥赛利定DUE标准切实可行,可为临床合理用药管理提供参考。

Abstract:

OBJECTIVE To establish drug utilization evaluation (DUE) standards for oliceridine injection, evaluate and analyze its clinical application, and provide a reference for promoting its rational clinical use. METHODS Based on drug package inserts, clinical practice guidelines, and expert consensus, the Delphi method was employed to establish the DUE standards for oliceridine, and the Attribute Hierarchy Model (AHM) was used to determine the comprehensive weights of the indicators. A retrospective study was conducted, in which the rationality of 493 discharged medical records from January 1, 2025, to November 30, 2025, was evaluated using the Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS). RESULTS The established DUE standards comprised 3 primary indicators (indication, administration process, and treatment outcome) and 11 secondary indicators (indications, contraindications, special populations, etc.). The secondary indicators with the highest weight coefficients were indications (0.0833) and contraindications (0.0833). A total of 493 medical records were included. According to the results of the weighted TOPSIS evaluation, 391 cases (79.3%) were rational, and 102 cases (20.7%) were basically rational. The primary types of irrational drug use involved use in special populations (42 cases, 8.5%) and exceeding daily dose limits or treatment duration (32 cases, 6.5%). CONCLUSION The clinical application of oliceridine is generally rational, but its usage requires further standardization. The established DUE standards for oliceridine are feasible and can serve as a reference for the management of rational clinical drug use.