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.

1.Planès A. Review of bemiparin sodium--a new second-generation low molecular weight heparin and its applications in venous thromboembolism[J]. Expert Opinion, 2003, 4(9): 1551-1561. DOI: 10.1517/14656566.4.9.1551.

2.Chapman TM, Goa KL. Bemiparin: a review of its use in the prevention of venous thromboembolism and treatment of deep vein thrombosis[J]. Drugs, 2003, 63(21): 2357-2377. DOI: 10.2165/00003495-200363210-00009.

3.Abbas MS. Bemiparin versus enoxaparin in the prevention of venous thromboembolism among intensive care unit patients[J]. Indian J Crit Care Med, 2017, 21(7): 419-423. DOI: 10.4103/ijccm.IJCCM_23_17.

4.Aydin Ozturk P, Yilmaz T, Ozturk U. Effects of bemiparin sodium versus dabigatran etexilate after anastomosis in rat carotid arteries on the development of neointima and thrombolytic efficacy[J]. World Neurosurg, 2019, 126: e731-e735. DOI: 10.1016/j.wneu.2019.02.139.

5.Loli-Ausejo D, Hernández-Martín I, Cabañas R, et al. Tranexamic acid plus bemiparin sodium as long-term prophylaxis in a patient with FXII-hae during pregnancy: a case report[J]. J Investig Allergol Clin Immunol, 2020, 30(6): 464-465. DOI: 10.18176/JIACI.0585.

6.Afanasjeva J, Burk M, Cunningham FF, et al. ASHP guidelines on medication-use evaluation[J]. Am J Health Syst Pharm, 2021, 78(2): 168-175. DOI: 10.1093/ajhp/zxaa393.

7.Sevastjanov P, Tikhonenko A. Direct Interval extension of TOPSIS method[C]. International Conference on Parallel Processing and Applied Mathematics, Poland: Lecture Notes in Computer Science, 2012, 7204: 504-512.

8.赵小丽, 朱倩倩,赵佩,等.基于加权TOPSIS法评价重组人血小板生成素的合理使用[J]. 中国医院药学杂志, 2022, 42(4): 431-434. [Zhao XL, Zhu QQ, Zhao  P, et al. Evaluation of recombinant human thrombopoietin utilization based on weighted TOPSIS method[J]. Chinese Journal of Hospital Pharmacy, 2022, 42(4): 431-434.] DOI: 10.13286/j.1001-5213.2022.04.16.

9.王晓明, 刘伟, 李静. 基于加权TOPSIS法的医院服务质量综合评价实践[J]. 中国医院统计, 2018, 25(4): 287-289. [Wang XM, Liu W, Li J. Based on the weighted TOPSIS method of hospital service quality comprehensive evaluation practice[J]. Chinese Journal of Hospital Statistics, 2018, 25(4): 287-289.] DOI: 10.3969/j.issn. 1006-5253.2018.04.016.

10.王桂凤, 李雪芹, 刘锐锋, 等. 基于加权TOPSIS法的利奈唑胺葡萄糖注射液药物利用评价[J]. 中国医院药学杂志, 2021, 41(23): 2464-2468. [Wang GF, Li XQ, Liu RF, et al. Evaluation of drug use of linezolid injection baseduon weighted TOPSIS method[J]. Chinese Journal of Hospital Pharmacy, 2021, 41(23): 2464-2468.] DOI: 10.13286/j.1001-5213.2021.23.14.

11.王乔宇, 武明芬, 柳鑫, 等. 2021中国静脉血栓栓塞症防治抗凝药物的选用与药学监护指南[J]. 中国临床药理学, 2021, 37(21): 2999-3016. [Wang QY, Wu MF, Liu X, et al. Guidelines for the selection and pharmaceutical care of anticoagulants for the prevention and treatment of venous thromboembolism in China of 2021[J]. The Chinese Journal of Clinical Pharmacology, 2021, 37(21): 2999-3016.] DOI: 10.13699/j.cnki.1001-6821.2021.21.032.

12.中国医师协会心血管内科医师分会心力衰竭学组, 中国心力衰竭患者高钾血症管理专家共识工作组. 中国心力衰竭患者高钾血症管理专家共识[J]. 中华医学杂志, 2021, 101(42): 3451-3458. DOI: 10.3760/cma.j.cn112137-20210624-01430.

13.中华医学会肾脏病学分会专家组. 中国慢性肾脏病患者血钾管理实践专家共识[J]. 中华肾脏病杂志, 2020, 36(10): 781-792. DOI: 10.3760/cma.j.cn441217-20200721-00139.

14.邓丽, 刘宏宇, 李鑫. 对体外生命支持组织的抗凝指南解读[J]. 中华肾脏病杂志, 2017, 15(2): 72-75. [Deng L, Liu HY, Li X. Interpretation of anticoagulation guidelines for extracorporeal life support tissues[J]. Chinese Journal of Extracorporeal Circulation, 2017, 15(2): 72-75.] DOI: 10.13498/j.cnki.chin.j.ecc.2017.02.03.

15.《中国血栓性疾病防治指南》专家委员会. 中国血栓性疾病防治指南[J]. 中华医学杂志, 2018, 98(36): 2861-2888. DOI: 10.3760/cma.j.issn.0376-2491.2018. 36.002.

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.姚书婷, 鄢金柱, 柯玉芳, 等. 低分子肝素联合物理治疗预防妇科肿瘤术后下肢深静脉血栓形成的网状Meta分析[J]. 医学新知, 2022, 32(2): 108-119. [Yao  ST, Yan JZ, Ke YF, et al. Low molecular weight heparin plus physiotherapy techniques in prevention of deep vein thrombosis in gynecological cancer patients undergoing major abdominopelvic surgery: a network Meta-analysis[J]. New Medicine, 2022, 32(2): 108-119.] DOI: 10.12173/j. issn.1004-5511.202109007.

18.超说明书用药循证评价规范: T/GDPA 1-2021[S]. 2021.

19.颜明明, 刘利月, 戴婷婷, 等. 低分子肝素类药物的临床应用[J]. 中国医药指南, 2018, 16(18): 39-40. [Yan MM, Liu LY, Dai TT, et al. Clinical application of low molecular weight heparin[J]. Guide of China Medicine, 2018, 16(18): 39-40.] DOI: 10.15912/j.cnki.gocm.2018.18.025.