中国临床药学杂志

目的建立罗沙替丁醋酸酯(RXTA)合理性评价标准,并采用属性层次模型(AHM)综合评价罗沙替丁醋酸酯临床应用的合理性。方法以罗沙替丁醋酸酯说明书、中华医学会、美国国立综合癌症网络等发布的相关指南和专家共识为依据,制定罗沙替丁醋酸酯合理性评价标准。采用回顾性研究方法对2020年1-6月260例应用罗沙替丁醋酸酯的归档病历进行分析、评价。结果罗沙替丁醋酸酯不合理的主要问题为药物经济性、超适应证用药和用法用量不适宜,次要问题为超疗程用药、未进行用药监护、治疗无效未调整方案及联合用药不合理。病历得分(MRS)≥90分的有50例(19%),80～90分的有6例(2%),60～80分的有156例(60%),<60分的有48例(18%)。结论罗沙替丁醋酸酯使用合理性较差,需加强管理,采用行政干预联合药学干预可提高罗沙替丁醋酸酯使用的安全性和有效性,降低药品费用。属性层次模型科学、合理、简单、实用,提供了一种新的药物合理性评价方法,评价结果真实可信,可在药物合理性评价中推广。

AIM To establish the evaluation criteria for roxatidine acetate(RXTA), and comprehensively evaluate the rationality of clinical practice of RXTA based on analytic hierarchical model. METHODS Based on the pharmaceutical instructions, evaluation criteria for rational use of RXTA were established with reference to clinical practice guidelines and expert consensus issued by the Chinese Medical Association and the National Comprehensive Cancer Network. A retrospective analysis method was used to rationally evaluate the 260 cases of archived medical records of patients who used RXTA during January to June 2020 in People's Hospital of Sanya. RESULTS The main unreasonable problems of RXTA were pharmacoeconomic, off-label use and unsuitable usage and dosage. The secondary unreasonable problems were over course of treatment, no medication monitoring, no adjustment of treatment plan after the treatment failed and unreasonable drug combination. Among the 260 cases, 50 cases(19%) had medical record score(MRS) ≥ 90, 6 cases(2%) had 80 ≤ MRS<90,156 cases(60%) had 60 ≤ MRS<80, and 48 cases(18%) had MRS<60. CONCLUSION The rational use of RXTA is poor, and the management should be strengthened, administrative intervention combined with pharmaceutical intervention is used to improve the safety and effectiveness and reduce the drug cost of RXTA. Analytic hierarchical model is scientific,reasonable, simple and practical, and it provides a new method of drug rationality evaluation and the evaluation results are authentic and reliable, which can be popularized in drug rationality evaluation.