Evaluation Method And Application Of Recombinant Human Insulin Rational Clinical Use

Objective: Recombinant human insulin is an important diabetes treatment, it has beenused increasingly widespread in a large number of medical institutions and clinicalapplications. Its lack of practical medicine standards, norms medication model,improved clinical drug evaluation and management model, greatly increased itsclinical drug risks. In this study, we applied the Delphi method to explore theestablishment of a rational clinical use of recombinant human insulin-evaluationsystem based on theoretical study for clinical medical institutions and provided areference in guiding and promoting clinical rational drug use.Method: In this study, we adopted literature review and experts discussion method toestablish framework of the evaluation indicator system from drug indications,medication administration process and medication results; we applied the Delphimethod eventually to establish clinical rational use of recombinant human insulin eachevaluation index and got the weight.We adopted synthetic scoring method to constructthe comprehensive evaluation model and selected100patients with HIS who haveused recombinant human insulin and looked back their cases, evaluated insulin withthe established comprehensive evaluation model rationality. We used SPSS (version17.0) to manage statistics analysis to distinguish different levels of boundaries andusing completely randomized design of one-way ANOVA to verify the application of integrated evaluation value obtained whether differences exist between each segment.Result: This study established the clinical rational use of recombinant humaninsulin-evaluation system, including three primary indicators: drug indications,medication administration process and results; thirteen secondary indicators: drugindications, including clinical diagnostic criteria, disease diagnosis, contraindicationsdisease, medication process, including route of administration, site of injection, bloodglucose monitoring, dose interval adjustment, combined with other antidiabetic drugssituation, combined with non-hypoglycemic conditions, diabetes education, medicationresults include signs and symptoms, control objectives, drugs adverse reactionmonitoring and disposal. In this study, conducted by expert advice, consulting Table26copies were issued,26were recovered, the recovery rate was100%; it has accountedfor81%of associate professors, the average working life of them was more than15years accounted for65%. Professional Distribution:15people were from clinicalpharmacy,10were from clinical medicine and one person was nurse. Expert averagecoefficient of determination (Ca) is0.92, the average familiarity factor (Cs) is0.62,expert authority coefficient (Cr) is0.77(>0.70), which showed a high degree ofcredibility of the results. The results presented that the degree of coordination expertopinion, an indicator of coordination coefficient ω=0.537, χ2=40.243, p=0.028,two indicators coordination coefficient ω=0.253, χ2=75.955, p=0.000, twoindicators p-value was below0.05,which displayed the test results were significant,indicating that experts on the evaluation of the index level of coordination is good. Theindicator system used expert consultation (Delphi method), concluding the weight ofeach index partition coefficient. Distinguished by statistical methods to verify thereasonableness of the level of medication has a better level of discrimination. Thecases were taken comprehensive evaluation results from0~57.23are severe irrationalcases,>57.23~65.46are moderate irrational cases,>65.46~73.69are mild irrational cases,73.69are irrational cases.Conclusion:1.We used Delphi Method to establish a rational clinical use ofrecombinant human insulin evaluation system;2. We determined the weight coefficients of each indicator and built comprehensiveevaluation model by comprehensive evaluation method of reliability analysis.Therelevant case studies validated the evaluation with good discrimination to the basicrequirements of the appropriate measurement science;3. The recombinant human insulin evaluation system established in this study can bequantitative and qualitative to evaluate clinical rational use of recombinant humaninsulin.