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吡咯替尼临床合理用药评价标准的建立与应用
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| 篇名： | 吡咯替尼临床合理用药评价标准的建立与应用 |
| TITLE： | Establishment and application of evaluation criteria for rational use of pyrotinib |
| 摘要： | 目的 建立吡咯替尼的临床合理用药评价（DUE）标准，促进其临床合理应用。方法以马来酸吡咯替尼片说明书为基础，以相关指导原则、诊疗指南等为评价依据，结合德尔菲法确定吡咯替尼的DUE标准；采用属性层次模型（AHM）和熵权法（EWM）对DUE标准各指标进行组合赋权，并运用加权逼近理想解排序（TOPSIS）法对海南省肿瘤医院和海南西部中心医院2019年11月－2023年11月使用吡咯替尼的归档病历进行用药合理性评价。结果所建的吡咯替尼DUE标准包括4个一级指标（处方权限、用药指征、用药过程、用药结果）和11个二级指标，组合权重较高的二级指标为给药途径及剂量（0.257）和说明书适应证（0.241）。在纳入的88例归档病历中，用药不合理的有28例（31.82%），用药基本合理的有43例（48.86%），用药合理的有17例（19.32%）；不合理的主要问题包括超说明书适应证（42.05%）、给药途径及剂量不合理（43.18%）。结论基于AHM-EWM-加权TOPSIS法建立吡咯替尼DUE标准，操作性强、评价结果可量化。该药在上述医院的使用整体合理性还有待提高，存在超说明书适应证和给药途径及剂量不合理等问题。 |
| ABSTRACT： | OBJECTIVE To establish drug utilization evaluation （DUE） criteria for pyrotinib to promote its appropriate application in clinical practice. METHODS Based on the label of Pyrotinib maleate tablets， with relevant guiding principles and diagnostic and treatment guidelines as the evaluation basis， DUE criteria for pyrotinib were determined through the Delphi method. Attribute hierarchical model （AHM） and entropy weight method （EWM） were used to combine and assign weights to each indicator within the DUE criteria. Additionally， the weighted technique for order preference by similarity to an ideal solution （TOPSIS） method was applied to perform rationality evaluation of medication in archived medical records from Hainan Provincial Tumor Hospital and Hainan Western Central Hospital regarding the use of pyrotinib from November 2019 to November 2023. RESULTS The established DUE criteria for pyrotinib included 4 primary indicators （prescription authority， indications for use， medication process， and medication outcomes） and 11 secondary indicators. The secondary indicators with higher weights were the route of administration and dosage （0.257） and indications in the label （0.241）. Among the 88 archived cases included， there were 28 cases of inappropriate medication （31.82%）， 43 cases of generally appropriate medication （48.86%）， and 17 cases of appropriate medication （19.32%）. The main issues related to inappropriate medication involved off-label use （42.05%） and inappropriate routes of administration and dosage （43.18%）. CONCLUSIONS DUE criteria for pyrotinib established using the AHM-EWM-weighted TOPSIS method is highly operational and results in quantifiable evaluation outcomes. The overall rationality of the use of pyrotinib in the above hospitals remains to be improved， and there are some issues， like the off-label use，and inappropriate routes of administration and dosage being liaoyylyy@163.com unreasonable. |
| 期刊： | 2025年第36卷第06期 |
| 作者： | 廖依依；李欣；夏耀文；赵红梅；陈青青 |
| AUTHORS： | LIAO Yiyi，LI Xin，XIA Yaowen，ZHAO Hongmei，CHEN Qingqing |
| 关键字： | 吡咯替尼；属性层次模型；熵权法；加权逼近理想解排序法；药物合理性评价 |
| KEYWORDS： | pyrotinib； AHM； EWM； weighted TOPSIS |
| 阅读数： | 12 次 |
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