1.Establishment and application of drug use evaluation standard of somatostatin for injection
Jiehong ZHANG ; Huiya CAI ; Liping CAI ; Yibo HAN ; Jinhua ZHANG
Chinese Journal of Pharmacoepidemiology 2024;33(4):381-387
Objective To establish the drug use evaluation(DUE)standard of somatostatin and evaluate the rationality of its clinical use,so as to provide a reference for the rationally clinical application of somatostatin.Methods Based on the specification of somatostatin for injection,related guidelines and literature,DUE standard was established.Evaluate the rationality and standardization of the use of somatostatin for injection at Beihai People's Hospital from January 2021 to December 2021 based on the established DUE standards.Results A total of 407 patients were included,with a medication reasonable rate of 94.84%.The irrational use of drug included unreasonable indications(13 cases,3.19%),unreasonable drug use frequency(7 cases,1.72%),and unreasonable drug interactions(1 case,0.25%).Conclusion The somatostatin for injection DUE standard established is feasible and practical.The clinical application of somatostatin for injection in this hospital is basically reasonable,but there are still some irrational use of somatostatin,which should be strengthened for intervention.
2.Drug use evaluation of ozagrel sodium based on weighted TOPSIS method
Shanshan ZHU ; Na WANG ; Huiya CAI ; Jinhua ZHANG
Chinese Journal of Pharmacoepidemiology 2024;33(2):137-144
Objective To establish evaluation of ozagrel sodium by weighted TOPSIS method so as to provide a reference for improving the rational use of ozagrel sodium.Methods Based on the drug instructions,guidelines,relevant literatures and Delphi method,the evaluation criteria for the clinical rationality of ozagrel sodium were formulated.Attribute hierarchical model(AHM)was used to assign weights to the indicators,the weighted TOPSIS method was employed to analyze and evaluate the rationality of 108 patients that discharged from the Third People's Hospital of Henan Province from January 2021 to April 2022.Results The reponse rates of two rounds of expert advice questionnaires were 100%,the authoritative coefficients(Cr)were 0.85,0.83(>0.70),and the experts fully affirmed the items of the standard.Among the 108 cases evaluated,37 cases(34.26%)were judged to be reasonable,52 cases(48.15%)were judged to be basically reasonable and 19 cases(17.59%)were judged to be unreasonable.The main unreasonable problems were manifested in indications,the timing of administration,drug course and monitoring of efficacy and laboratory parameters.Conclusion The method of DUE of ozagrel sodium based on weighted TOPSIS is more comprehensively and intuitively.The application of ozagrel sodium in the hospital is relatively standardized,but there are problems in the course of medication,indications,and timing of administration.So it is necessary to promote the rational use by strengthening the cooperation between pharmacists and physicians,and improving pharmaceutical intervention.
3.Drug use evaluation of bemiparin sodium injection based on weighted TOPSIS method
Lulu TIAN ; Meijuan LI ; Deqiu ZHU ; Huiya CAI ; Jinhua ZHANG
Chinese Journal of Pharmacoepidemiology 2024;33(5):481-488
Objective To establish the drug use evaluation(DUE)criteria for bemiparin sodium injection,and evaluate the use of bemiparin sodium injection by weight technique for order prefer by similarity to ideal solution(TOPSIS),and to provide reference for improving the rational use of bemiparin sodium injection.Methods Based on the instructions of bemiparin sodium injection,and referring to relevant guidelines and literatures,the DUE criteria of bemiparin sodium injection was established by expert consultation.The weighted TOPSIS method was used to evaluate the rationality medication in the cases of inpatients who use bemiparin sodium injection from June to July 2021 in the Tongji Hospital of Tongji University.Results In the established DUE criteria of bemiparin sodium injection,the top two relative weight coefficients of ten secondary indicators were contraindications and adverse reaction disposal,and the bottom two were administration methods and indications.A total of 100 medical records were including.There was not a case close to the optimal regimen(Ci≥0.8)(reasonable);Ci was between 0.6 and 0.8(basically reasonable)in 83 cases(83.00%);and Ci<0.6(unreasonable)in 17 cases(17.00%).The unreasonable uses of bemiparin sodium injection mainly appeared in off-lable uses of indications and the dosing method,a potential drug-drug interaction,inappropriate dosage,and violation of drug contraindications.Conclusion The drug use evaluation method of bemiparin sodium injection based on weighted TOPSIS method can synthesize multiple evaluation indexes,and the evaluation results are objective and reliable.The results showed that most clinical application of bemiparin sodium injection in this hospital was basically reasonable,but to provide basis for rational clinical drug use and to ensure patients'medication safety,it is necessary to accelerate the off-label evidence-based evaluation process and strengthen the management of rational drug use.
4.Rationality evaluation of alteplase in the treatment of acute ischemic stroke based on weighted TOPSIS method
Sitong GUO ; Huiya CAI ; Henghai SU ; Jinhua ZHANG
Chinese Journal of Pharmacoepidemiology 2024;33(6):642-651
Objective To establish a drug use evaluation(DUE)criteria for alteplase in the treatment of acute ischemic stroke(AIS),and to evaluate the use of the drug by weighted TOPSIS method,to provide a reference for rational use of alteplase.Methods Based on the drug package insert,relevant guidelines,the DUE criteria for alteplase in the treatment of AIS were developed combined with expert consultation.The weighted TOPSIS method was used to evaluate the rationality of alteplase use in inpatients with AIS in the People's Hospital of Guangxi Zhuang Autonomous Region from January 2020 to June 2022,based on the attribute hierarchy model.Results A total of 126 medical records were included.Among them,80 cases(63.49%)exhibited a high degree of adherence(C,>0.8)between the prescribed drug regimens and the optimal recommendations,which was considered reasonable.Additionally,40 cases(31.75%)fell within the range of 0.6 ≤ Ci ≤ 0.8,indicating a basic reasonable adherence,and 6 cases(4.76%)had a C,<0.6,suggesting an unreasonable level of adherence.The irrational use of the drug mainly involved contraindications(32.54%),dosage(7.14%),and drug conversion(7.14%),among other aspects.Conclusion The weighted TOPSIS method is used to evaluate the rationality of alteplase in the treatment of acute ischemic stroke(AIS),and the results are intuitive and comprehensive.There are still problems in the use of alteplase in this hospital,and it is necessary to strengthen intervention to promote rational clinical use of alteplase in terms of contraindication of medication and dosage,etc.
5.Establishment and application of drug use evaluation criteria of recombinant human prourokinase
Zhihe ZHUANG ; Qin QIN ; Huiya CAI ; Tianyu MA ; Runqiu WANG ; Qian XIANG ; Jinhua ZHANG
Chinese Journal of Pharmacoepidemiology 2024;33(4):371-380
Objective To establish the drug use evaluation(DUE)criteria of recombinant human prourokinase(rhPro-UK),and to provide reference for the rational clinical application of rhPro-UK.Methods Based on the drug instructions of rhPro-UK,DUE standard rules were established by referring to relevant guidelines,expert consensus,authoritative literature and expert consultation.The medical records of hospitalized patients treated with rhPro-UK from January 2019 to May 2022 in Xilin Gol League Central Hospital were evaluated by retrospective investigation.The effectiveness of rhPro-UK was evaluated based on clinical outcome,and its safety was evaluated based on the incidence and severity of adverse reactions.Results A total of 230 cases were included,and 4 cases fully met the evaluation criteria(medication indication,medication process,medication results),accounting for 1.74%.There were 226 patients(98.26%)with irrational drug use,mainly manifested in two aspects of drug indication and drug process(administration mode and dosage).Treatment was effective in 221 patients,with an overall effective rate of 96.09%;139 patients experienced adverse reactions,with an incidence rate of 60.43%.Conclusion The clinical use of rhPro-UK in our hospital is irrational in the indication of medication and the process of medication,and the establishment of the DUE standard rules of rhPro-UK can provide a reference to standardize the clinical application of rhPro-UK and promote its rational use.