Establishment And Application Of The Evaluation Method For Clinical Rational Use Of Saxagliptin

Objective: DPP-IV is a new antidiabetic drug with different mechanism in recent years.This kind of medicine has good curative effect and less adverse reactions when used alone or in combination.Its representative drug,Saxagliptin,is widely used in a hospital.There are some irregularities in the process of clinical application of Saxagliptin,and there is no perfect evaluation standard and appropriate regulatory measures.Through the establishment of the evaluation index and standard of rational use of saxagliptin to evaluate the rationality of the use of saxagliptin in the hospital,and to provide the basis for promoting the clinical rational use of saxagliptin.Methods:1.Based on the drug instructions,clinical guidelines,clinical pathways,and related references,more than ten experts from clinical endocrinology department and pharmacy department,were consulted to develop the evaluation indicators and standards of Saxagliptin.2.AHP is used to score the relative importance of each secondary index in the evaluation standard,and a judgment matrix is constructed.After the consistency test,the relative weight of each index is calculated by the formula.3.Through the method of retrospective analysis,106 cases of saxagliptin in endocrine Department of a hospital in the past half year were read out,and the clinical use was analyzed and evaluated by TOPSIS method based on AHP weighting.Results:1.According to the evaluation criteria of saxagliptin,6 first-class and 12 second-class indexes were established from three aspects: indication,process and results.Six primary indicators include: indication of drug use,usage,combination of drugs,education related to diabetes treatment and blood glucose monitoring,clinical treatment objectives and efficacy,occurrence and treatment of adverse reactions.12 primary indicators include: indications,drug selection,dosage and adjustment,frequency of drug administration,route of drug administration,timing of drug administration,interaction and adjustment,basic content of diabetes education,blood glucose monitoring during drug administration,target of index control,symptoms and signs,ADR and treatment.In the evaluation standard,the evaluation basis and result judgment standard of each secondary evaluation index are defined.2.AHP method was used to score the importance of secondary indicators,establish a judgment matrix,and calculate the relative weight of each indicator by formula through consistency test.The top three indexes were indications(weight 0.25),dosage and adjustment(weight 0.21),and frequency of Administration(weight 0.15).3.TOPSIS method based on AHP weighting was used to evaluate the rationality of 106 cases,of which 39.6% were reasonable cases,50.9% were basic reasonable cases and 9.4% were unreasonable cases.Conclusion:The TOPSIS method weighted by AHP is reasonable and feasible in evaluating the rationality of Saxagliptin.But there are still some problems.