中国临床药学杂志

目的 探讨癌痛药物治疗中多模式干预措施（包括合理用药培训、处方前置审核、合理用药评价和行政管理）对非甾体抗炎药（NSAIDs）使用合理性的影响。方法 选取医院2023年10月至12月225例使用NSAIDs治疗癌痛的病例作为干预前组，2024年4月至9月259例使用NSAIDs治疗癌痛，并实施多模式干预措施的病例作为干预后组。通过建立的药物利用评价标准，采用属性层次模型法对干预前组、干预后组病例的合理性进行评分，进而对多模式干预效果进行评价。结果 干预前组病例合理性得分为80.64(75.18,89.09)分，干预后组病例合理性得分为91.55(89.09,100)分，差异具有统计学意义（P<0.05）；干预前组用于治疗癌痛的NSAIDs药品费用为41.00(41.00,97.85)元，干预后组为41.00(41.00,82.00)元，差异无统计学意义（P > 0.05）；干预后组适应证、基本原则、疗程及日限制剂量、用药监护指标的合理性较干预前组均得到了明显提升，差异具有统计学意义（P<0.05）。结论 多模式干预措施具有协同作用，形成全程管理模式，在不增加药品费用的情况下能有效地提高NSAIDs在癌痛药物治疗中的使用合理性。

AIM To explore the impact of multi-modal intervention measures(including rational drug use training, pre-prescription review, rational drug utilization review, and administrative management) on the rational use of non-steroidal anti-inflammatory drugs(NSAIDs) in medication treatment for cancer pain management. METHODS A total of 225 patients using NSAIDs for cancer pain drug treatment who discharged from People's Hospital of Bozhou from October to December 2023 were selected as the pre-intervention group, and 259 patients using NSAIDs for cancer pain drug treatment who accepted the multi-modal intervention and discharged from April to September 2024 were selected as the post-intervention group. Using the established criteria for drug utilization review, the rationality of the pre-intervention and post-intervention groups was scored with the attribute hierarchical model method. The effectiveness of the multi-modal intervention was then statistically analyzed. RESULTS The medical record score was 80.64(75.18, 89.09) in the preintervention group, and increased significantly to 91.55(89.09, 100) in the post-intervention group(P < 0.05). The drug cost of NSAIDs for cancer pain was 41.00(41.00, 97.85) yuan in the pre-intervention group and 41.00(41.00, 82.00) yuan in the post-intervention group, and the difference was not statistically significant(P > 0.05). The rationality of indications, basic principles, treatment courses and daily limit doses, medication monitoring indicators was significantly improved after multi-modal intervention, with a statistically significant difference(P < 0.05). CONCLUSION Multi-modal interventions could collaborate to create a comprehensive approach that effectively enhances the rational use of NSAIDs in treating cancer pain, without increasing drug costs.