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.

1.赖琪, 胡明, 蒲剑, 等. 药物利用评价与医院质量保证[J]. 中国药师, 2001, 4(6): 451-453. [Lai Q, Hu M, Pu J, et al. Drug use review and hospital quality assurance[J]. China Pharmacist, 2001, 4(6): 451-453.] DOI: 10.3969/j.issn.1008-049X.2001.06.025.

2.黄秋萍, 郑淑敏, 骆琼莲, 等. DUE临床药学工作模式实践[J]. 医学理论与实践, 2019, 32(17): 2815-2817. [Huang QP, Zheng SM, Luo QL. The practice of DUE clinical in pharmacy work model practice[J]. Journal of Medical Theory and Practice, 2019, 32(17): 2815-2817.] DOI: 10.19381/j.issn.1001-7585.2019.17.074.

3.Phillips MS, Gayman JE, Todd MW. ASHP guidelines on medication-use evaluation. American Society of Health-system Pharmacists[J]. Am J Health Syst Pharm, 1996, 53(16): 1953-1955. DOI: 10.1093/ajhp/53.16.1953.

4.Zolfagharian F, Ghazanfari S, Elyasi S, et al. Drug utilization evaluation of albumin in a teaching hospital of Mashhad, Iran: aninterventional pre-post design study[J]. Int J Clin Pharm, 2017, 39(4): 704-711. DOI: 10.1007/s11096-017-0458-y.

5.Faley B, Fanikos J. Best practices for medication utilization evaluations in postsurgical pain management[J]. Curr Emerg Hosp Med Rep, 2017, 5(1): 33-40. DOI: 10.1007/s40138-016-0121-2.

6.Mankadavath A, Chandrasekhar D, Thomas T, et al. A prospective drug use evaluation of antihypertensive drugs in in-patients of a tertiary referral care hospital[J]. J Basic Clin Physiol Pharmacol, 2015, 26(3): 295-300. DOI: 10.1515/jbcpp-2013-0131.

7.宋佳伟, 刘丽, 徐珊珊, 等. 基于加权TOPSIS法的艾迪注射液合理性评价[J]. 中南药学, 2019, 17(1): 125-128. [Song JW, Liu L, Xu SS, et al. Evaluation of reasonableness Aidi injection based on weighted TOPSIS method[J]. Central South Pharm, 2019, 17(1): 125-128.] DOI: 10.7539/j.issn.1672-2981.2019.01.029.

8.魏博楠, 陶娌娜, 张杰, 等. 奥扎格雷钠联合银杏达莫治疗急性脑梗死有效性和安全性的Meta分析[J] 中西医结合心脑血管病杂志, 2020, 18(13): 2052-2059. [Wei BN, Tao LN, Zhang J, et al. Efficacy and safety of ozagrel sodium combined with Ginkgo Damo in the treatment of acute cerebral infarction: a meta-analysis[J]. Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease, 2020, 18(13): 2052-2059.] DOI: 10.12102/j.issn. 1672-1349.2020.13.008.

9.曾超, 郑芳, 陈星, 等 .奥扎格雷钠治疗脑梗死有效性,安全性及经济性的卫生技术评估[J]. 中国处方药, 2022, 20(4): 38-42. [Zeng C, Zheng F, Chen X, et al. Health technology evaluation of efficacy, safety and economy of Ozagrel Sodium in the treatment of cerebral infarction[J]. Journal of China Prescription Drug, 2022, 20(4): 38-42.] DOI: 10.3969/j.issn.1671-945X.2022.04. 014.

10.卫生部合理用药专家委员会, 编写. 中国医师药师临床用药指南[M]. 重庆: 重庆出版社, 2009: 855-856.

11.中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志, 2018, 51(9): 666-682. DOI: 10.3760/cma.j.issn.1006-7876.2018.09.004.

12.Shinohara Y, Yamaguchi T. Outline of the Japanese Guidelines for the Management of Stroke 2004 and subsequent revision[J]. Inter J Stroke, 2008, 3(1): 55-62. DOI: 10.1111/j.1747-4949.2008.00178.x.

13.Miyamoto S, Ogasawara K, Kuroda S, et al. Japan Stroke Society guideline 2021 for the treatment of stroke[J]. Int J Stroke, 2022, 17(9): 1039-1049. DOI: 10.1111/j.1747-4949.2008.00178.x.

14.龙一文, 陈勇. Delphi法在医院药事管理工作评价指标体系设计中的应用[J]. 中国医院药学杂志, 2017, 37(2): 181-184. [Long YW, Chen Y. Application of Delphi method in the design of evaluation index system of hospital pharmacy administratio[J]. Chinese Journal of Hospital Pharmacy, 2017, 37(2): 181-184.] DOI: 10.13286/j.cnki.chinhosppharmacyj.2017.02.19.

15.蒋莹莹, 詹尧平, 徐翔翔. LIKERT五分量表法在建立儿科人血白蛋白临床应用评价标准的应用[J]. 儿科药学杂志, 2023, 29(1): 1-4. [Jiang YY, Zhan YP, Xu XX. Establishment and application of clinical evaluation criteria for pediatric human serum albumin based on Likert five subscale method[J]. Journal of Pediatric Pharmacy, 2023, 29(1): 1-4. DOI: 10.13407/j.cnki.jpp.1672-108X. 2023.01.001.

16.苏广全, 陈慧, 桂双英, 等. 基于德尔菲法构建医疗机构药品目录管理评价指标体系[J]. 药物流行病学杂志, 2023, 32(1): 30-35. [Su GQ, Chen H, Gui SY, et al. Construction of hospital medicine list management index system based on Delphi method[J]. Chinese Journal of Pharmacoepidemiology, 2023, 32(1): 30-35.] DOI: 10.19960/j.issn.1005-0698.202301005.

17.张鹏程, 宋佳伟, 王雪倩, 等. 基于属性层次模型的法莫替丁药物合理性评价[J]. 中国药物应用与监测, 2022, 19(4): 258-261. [Zhang PC, Song JW, Wang XQ, et al. Rationality evaluation of famotidine based on attribute hierarchical model[J]. Chinese Journal of Drug Application and Monitoring, 2022, 19(4): 258-261.] DOI: 10.3969/j.issn.1672-8157.2022.04.013.

18.程乾生. 属性层次模型AHM— 一种新的无结构决策方法[J]. 北京大学学报(自然科学版), 1998, (1): 12-16. [Cheng GS. Attribute hierarchy model AHM: A new unstructured decision making method[J]. Acta Scientiarum Naturalium Universitatis Pekinensis, 1998, (1): 12-16.] DO1: 10.13209/j.0479-8023.1998.003.

19.咎昕, 胡鑫, 王婕, 等. 出凝血功能障碍相关性脑出血中国多学科诊治指南[J]. 中国急救医学, 2021, 41(8): 647-660. [Zan X, Hu X, Wang J, et al. Chinese guidelines for diagnosis and treatment of cerebral hemorrhage associated with coagulation dysfunction[J]. Chinese Journal of Critical Care Medicine, 2021, 41(8): 647-660.] DOI: 10.3969/j.issn.1002-1949.2021.08.002.

20.李超, 杨子贤, 罗太敏, 等. 奥扎格雷钠注射液治疗急性血栓性脑梗死的快速卫生技术评估[J]. 中国医院用药评价与分析, 2020, 20(7): 836-848. [Li C, Yang ZX, Luo TM, et al. Rapid health technology assessment of ozagrelay sodium injection for acute cerebral infarction[J]. Evaluation and Analysis of Drug-Use in Hospitals of China, 2020, 20(7): 836-848.] DOI: 10.14009/j.issn.1672-2124.2020.07.018.

21.李晓芳, 刘芳, 汤骐羽. 奥扎格雷钠注射液治疗进展性脑卒中的有效性和安全性的Meta分析[J]. 中国合理用药探索, 2022, 19(1): 15-26. [Li XF, Liu F, Tang QY, et al. Efficacy and safety of ozagrel sodium injection in the treatment of progressing stroke: a meta analysis[J]. Chinese Journal of Rational Drug Use, 2022, 19(1): 15-26.] DOI: 10.3969/j.issn.2096-3327.2022.01.003.

22.Wu CM, McLaughlin K, Lorenzetti DL, et al. Early risk of stroke after transient ischemic attack: a systematic review and meta-analysis[J]. Arch Intern Med, 2007, 167(22): 2417-2422. DOI: 10.1001/archinte.167.22.2417.

23.Giles MF, Rothwell PM. Risk of stroke early after transient ischaemic attack: a systematic review and meta-analysis[J]. Lancet Neurol, 2007, 6(12): 1063-1072. DOI: 10.1016/S1474-4422(07)70274-0.

24.Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 Guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association[J]. Stroke, 2021, 52(7): e364-e467. DOI: 10.1161/STR.0000000000000375.

25.中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国缺血性卒中和短暂性脑缺血发作二级预防指南2022[J]. 中华神经科杂志, 2022, 55(10): 1071-1110. DOI: 10.3760/cma.j.cn113694-20220714-00548.

26.Park SI, Park SK, Jang KS, et al. Preischemic neuroprotective effect of minocycline and sodium ozagrel on transient cerebral ischemic rat model[J]. Brain Res, 2015, 1599: 85-92. DOI: 10.1016/j.brainres.2014.12.051.

27.赵青, 张丽君, 李俊武, 等. 奥扎格雷钠治疗短暂性脑缺血发作的临床观察及对预后的影响[J]. 中国动脉硬化杂志, 2008, 16(1): 50-52. [Zhao Q, Zhang LJ, Li JW, et al. The therapeutic effect and prognosis of sodium ozagrel on treatment of transient ischemic attack[J]. Chinese Journal of Arteriosclerosis, 2008, 16(1): 50-52.] DOI: 10.3969/j.issn.1007-3949.2008.01.013.

28.柳国栋. 奥扎格雷钠与灯盏花素对老年短暂性脑缺血发作的治疗效果[J]. 大家健康(中旬版), 2017, 11(1): 126-127. [Liu GD. Ozagrel sodium combined with breviscapine on the treatment of senile transient ischemic attack[J]. For All Health, 2017, 11(1): 126-127.] DOI: 10.3969/j.issn.1009-6019.2017.01.169.

29.宗学莉, 金伟, 刘郅红. 奥扎格雷钠治疗短暂性脑缺血发作临床观察[J]. 中国实用医药, 2011, (17): 153-154. [Zong XL, Jin W, Liu ZH. The research of clinical effects of sodium ozagrel on treating transient ischemic attack[J]. China Practical Medicine, 2011, (17): 153-154.] DOI: 10.3969/j.issn.1673-7555.2011.17.115.

30.中国医师协会神经内科医师分会脑血管病学组. 急性脑梗死缺血半暗带临床评估和治疗中国专家共识[J].中国神经精神疾病杂志, 2021, 47(6): 12. DOI: 10.3969/j.issn.1002-0152.2021.06.002.

31.Kern R, Nagayama M, Toyoda K, et al. Comparison of the European and Japanese guidelines for the management of ischemic stroke[J]. Cerebrovasc Dis, 2013, 35(5): 402-418. DOI: 10.1159/000351753.

32.孙博, 刘勋, 张二锋, 等. 基于加权TOPSIS法的亚胺培南西司他丁药物利用评价[J]. 药物流行病学杂志, 2021, 30(12): 827-832. [Sun B, Liu X, Zhang EF, et al. Evaluation of drug use evaluation of imipenem and cilastatin based on weighted TOPSIS method[J]. Chinese Journal of Pharmacoepidemiology, 2021, 30(12): 827-832.] DOI: 10.19960/j.cnki.issn1005-0698.2021.12.008.