药学监护路径对聚乙二醇化重组人粒细胞刺激因子用药合理性的影响.docx

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1、药学监护路径对聚乙二醇化重组人粒细胞刺激因子用药合理性的影响温嘉瑶I2,又囱卜莹2/毓契，刘香芳2(1华南理工大学生物科学与工程学院，广东广州510006；2.华南理工大学附属第二医院&广州第一人民医院临床药学科，广东广州510180)摘要目的:分析聚乙二醵化重组人粒细胞刺激因子(pegylatedrecombinanthumangranulocytecolonystimulatingfactor,PEGrhG-CSF)合理使用情况，并评估药学监护路径在PEGrhG-CSF合理使用中的作用方法以PEGrhG-CSF药学监护路径为指导，对PEG-rhG-CSF患者进行药学干预服务根据PEG-rh

2、G-CSF说明书、相关指南等，制定PEG-rhG-CSF合理性评价标准，结合层次分析法(analyticalhierarchyprocess.AHP)与优劣解区疆法(techniquefororderpreferencebysimilaritytosolution,ToPSIS),对干预前后PEG-rhG-CSF的合理性进行综合性评价，比较干预前后PEG-rhG-CSF合理性差异结果:建立包括3个一级指标和10个二级指标的评价体系对照组1085病例中，完全合理(C=I)占22.86%(248/1085),基本合理(0,60.8)占60.28%(654/1085)不合理(a0,6)占16.87%

3、(183/10851;经药学干预后PEG-rhG-CSF完全合理、基本合理、不合理分别占50.00%(122/244),47.95%(117/244).2.04%(5/244),两组差异有统计学意义(PQ.01).对照组不合理主要体现在给药时机不合理、无适应证给药、给药剂量不合理、用药后无血常规监测、重复用药等，干预后，以上不合理情况大幅度减少(哨0.01).结论:基于AHP-TOPSlS法建立PEGjhG-CSF合理性评价标准有效、可行.PEG-rhG-CSF药学监护路径能有效地提高PEG-rhG-CSF使用合理性，后续可以此为导向为使用PEG-rhG-CSF患者提供个体化药学服务。关键词聚

4、乙二醇化人重组粒细胞刺激因子；药学监护路径；合理用药；层次分析法；优劣解距离法；药师干预中图分类号R969.3文献标识码A文章编号1001-5213(2023)18-2076-05DOI:10.13286/j.1001-5213.2023.18.13TheeffectofpharmaceuticalcarepathwayontherationalityofPegylatedrecombinanthumangranulocytestimulatingfactorWENJiayao12DENGXiaoying2/NISuiqin2LluXiangfang2(1.SchoolofBiologyand

5、BiologicalEngineering,SouthChinauniversityofTechnology,GuangdongGangzhou510006，China；2.DepartmentofClinicalPharmacy.TheSecondAffiliatedHospitalofSouthChinauniversityofTechnology&GuangzhouFirstPeople,sHospital,GuangdongGuang-zhou510080，China)ABSTRACT:OBJECTIVEThepurposeofthisstudywastoanalyzePEG-rhG-

6、CSFrationaluse,andevaluatetheroleofpharmaceuticalcarepathwayinPEG-rhG-CSFrationaluse.METHODSAftertheestablishmentofthePEG-rhG-CSFpharmaceuti-calmonitoringpathwaypharmaceuticalinterventionserviceswereprovidedtoPEG-rhG-CSFpatientsunderitsguidance.BasedonPEG-rhG-CSFinstructionsandrelatedguidelines,etc.

7、，thePEG-rhG-CSFrationalityevaluationcriteriawereformulated.CombiningAnalyticalHierarchyProcess(AHP)andtechniquefororderpreferencebysimilaritytosolution(TOPSIS).thera-tionalityofPEG-rhG-CSFbeforeandafterinten/entionwasmprehensivelyevaluated，andtherationalitydifferenceofPEG-rhG-CSFbeforeandaftertheint

8、erventionwascompared.RESULTSTheestablishmentoftheevaluationsystemincluds3primaryindicatorsandIOsecondaryindicators.Amongthe1085casesinthecontrolgroup,completelyreasonable(o=1)ac-untedfor22.86%(248/1085).basicallyreasonable(0.60.8)accountedfor60.28%(654/1085),andunreasonable(G0.6)acuntedfor16.87%(183

9、/1085)；afterpharmaceuticalintervention,PEG-rhG-CSFwascompletelyreasonable,basicallyreasonableandunreasonable，respectivelyaccountingfor50.00%(122/244),47.95%(117/244),2.04%(5/244).Thedifferencebetweentwogroupswasstatisticallysignificant(PQ.01).Theirrationalitiesofthentrolgroupweremainlyreflectedinthe

10、irrationaltimeofadministration,drugadministrationwithoutindications,unreasonabledosage，nobldroutinemonitoringafterinjection.repeatprescription，etc.Aftertheintervention，theaboveirrationalitiesweresignificantlyreduced(bothP08为用药合理，0.6三Cr0.8为基本用药合理，c06为不合理用药。表1肿瘤患者应用PEG-rhG-CSF合理性评价标准TabIEVaIUationCriteriaforrationalIISeOfPEG-rhG-CSFintumorPatien