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小剂量利伐沙班用于动脉粥样硬化性心血管疾病的药物利用评价标准构建与应用
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| 篇名： | 小剂量利伐沙班用于动脉粥样硬化性心血管疾病的药物利用评价标准构建与应用 |
| TITLE： | Construction and application of the criteria for drug utilization evaluation of low-dose rivaroxaban in atherosclerotic cardiovascular disease |
| 摘要： | 目的 基于双通道抑制（DPI）抗栓治疗方案构建小剂量利伐沙班用于动脉粥样硬化性心血管疾病（ASCVD）的药物利用评价（DUE）标准并应用，以促进临床合理用药。方法以小剂量利伐沙班（2.5mg，bid）药品说明书、相关指南共识为依据，采用德尔菲法建立小剂量利伐沙班用于ASCVD的DUE标准，采用加权逼近理想解排序（TOPSIS）法确定各评价指标的权重系数，并对本院2024年2月1日至2025年1月31日使用小剂量利伐沙班治疗ASCVD的出院患者病历进行合理性评价。结果所建的DUE标准包括3个一级指标（用药指征、用药过程和用药结果）和11个二级指标（如适应证、禁忌证等）。权重系数较高的二级指标为禁忌证（0.1179）和适应证（0.1121）。共纳入265份病历进行评价，其中合理病历192份（占72.45%）、基本合理病历69份（占26.04%）、不合理病历4份（占1.51%）；不合理类型主要包括联合用药不适宜、用法用量不适宜、用药后监测不适宜、药物转换不适宜等。结论本研究基于DPI抗栓治疗方案建立了小剂量利伐沙班用于ASCVD的DUE标准，其评价结果直观、可靠、可量化。本院小剂量利伐沙班在ASCVD患者中的使用较为合理，但仍需进一步加强管理。 |
| ABSTRACT： | OBJECTIVE To construct and apply drug utilization evaluation （DUE） criteria for low-dose rivaroxaban in atherosclerotic cardiovascular disease （ASCVD） based on the dual pathway inhibition （DPI） antithrombotic therapy scheme， to promote clinical rational drug use. METHODS Based on the instructions and relevant guidelines of low-dose rivaroxaban （2.5 mg， bid）， the Delphi method was used to establish the DUE criteria for low-dose rivaroxaban used in ASCVD. Weighted technique for order preference by similarity to an ideal solution method was used to determine the relative weights of each evaluation index， and the rationality of the filing medical records of discharged patients using low-dose rivaroxaban for ASCVD at Anqing Municipal Hospital from February 2024 to January 2025 was evaluated. RESULTS The established DUE criteria included 3 primary indicators （medication indications， medication process， medication results） and 11 secondary indicators （such as indications， contraindications， etc.）. The higher weighted secondary indicators being contraindications （0.117 9） and indications （0.112 1）. A total of 265 medical records were included for evaluation. The evaluation results showed that 192 cases （72.45%） had reasonable medical records， 69 cases （26.04%） had basic reasonable medical records， and 4 cases （1.51%） had unreasonable medical records； unreasonable types mainly included inappropriate combination therapy， inappropriate usage and dosage， inappropriate post- medication monitoring， and inappropriate drug switching， etc. CONCLUSIONS This study establishes a DUE criteria for low-dose rivaroxaban in ASCVD based on the DPI antithrombotic treatment regimen， and the evaluation results are intuitive， reliable， and quantifiable. The use of low-dose rivaroxaban in ASCVD patients in our hospital is relatively reasonable， but further management needs to be strengthened. |
| 期刊： | 2025年第36卷第17期 |
| 作者： | 吴亮；王威；徐扬慧；朱波；柯义君 |
| AUTHORS： | WU Liang，WANG Wei，XU Yanghui，ZHU Bo，KE Yijun |
| 关键字： | 利伐沙班；双通道抑制抗栓治疗；动脉粥样硬化性心血管疾病；药物利用评价 |
| KEYWORDS： | rivaroxaban； dual pathway inhibition antithrombotic treatment regimen； atherosclerotic cardiovascular disease； |
| 阅读数： | 7 次 |
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