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    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

      摘要
    • 摘要:
      目的  基于属性层次模型(attribute hierarchy model，AHM)和逼近理想值排序(technique for order preference by similarity to an ideal solution，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月苏州大学附属第二医院开具的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3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、药物不良反应处理和禁忌证；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。该药在苏州大学附属第二医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 in the Second Affiliated Hospital of Soochow University. The evaluation results were divided into three levels including reasonable, basic reasonable and unreasonable application based on the compliance index(Ci).
      RESULTS The evaluation indexes for evaluating the rational use of oliceridine, ranked by relative weight, placed the top three as indications(weight 0.1635), dosage and administration(weight 0.1472), and route of administration(weight 0.1361). Among 260 prescriptions evaluated using the oliceridine rational use criteria, the indicators with the highest to lowest rates of irrational use were economy, concomitant medication, dosage and administration, efficacy evaluation, special populations, adverse drug reaction management, and contraindications. According to the weighted TOPSIS method, 55 prescriptions(21.15%) were classified as reasonable(Ci≥80%), 11 prescriptions(4.23%) as basic reasonable(60%≤Ci<80%), and 194 prescriptions(74.62%) as unreasonable (Ci<60%).
      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 the Second Affiliated Hospital of Soochow University, and the management should be strengthened in clinical application.

       

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