Establishment And Application Of Evaluation System For Rational Use Of New Anti-tumor Drugs Rituximab And Camrelizumab

The application of anti-tumor drugs involved multiple clinical disciplines.Improving the efficacy and reducing the incidence of adverse reactions were the key to the rational application of anti-tumor drugs,and it was also an indispensable part of the rational use of health resources.In order to standardize the clinical use of new anti-tumor drugs and further improve the technical level of scientific and rational use of drugs for cancer patients,this study established a comprehensive evaluation system for the rational use of new anti-tumor drugs and discussed its application effects,which provided a reference basis for the scientific and rational use of new anti-tumor drugs in clinical treatment.This study attempted to establish a comprehensive evaluation system for the rational use of the new anti-tumor drugs rituximab and camrelizumab,and used this system to evaluate the use of these two drugs in the Affiliated Hospital of Qingdao University,analyzed the outstanding problems found in the evaluation process,and proposed rectification countermeasures,re-evaluated the medication situation after rectification,and checked the rectification effect.By consulting the instructions of rituximab and camrelizumab,combined with clinical diagnosis and treatment guidelines,clinical pathways and related literature,according to the actual use of Affiliated Hospital of Qingdao University,experts in the fields of oncology,lymphoma,hematology and pharmacy jointly formulated clinical medication rationality evaluation indicators and evaluation standards.The indexes were divided into primary indicators and secondary indicators by using the attribute analytic hierarchy process(AHP),the importance of different indexes was scored,and the judgment matrix was constructed.After passing the consistency test,with the help of the relevant formulas of the attribute analytic hierarchy process,the following conclusions were drawn.The weighted technique for order preference by similarity to an ideal solution(TOPSIS)was used to evaluate the medical records.After the establishment of the index system,the medical big data system of Affiliated Hospital of Qingdao University was retrieved through a retrospective analysis method.Patients who used rituximab from July 2020 to December 2020 and patients who used camrelizumab from January 2021 to September 2021 were collected as the pre-intervention group.Each case information was assigned a value to the control index to form a corresponding matrix.After normalization,the optimal and worst solutions were obtained,calculated the Euclidean distance and evaluated the rationality of the patient’s medication.The outstanding problems revealed by the evaluation results of the pre-intervention group were summarized and analyzed,and the corrective measures were put forward.The patients who used rituximab from July 2021 to December 2021 were collected as the post-intervention group,and the rationality of medication after the rectification was evaluated,compared with that before the intervention,and the intervention effect was observed.The evaluation standard of rational drug use was established from the different aspects of drug indications,drug use process and adverse reactions of rituximab and camrelizumab.Each index was ranked according to the weight coefficient,and the higher the value,the higher the importance.Rituximab was included in 3 primary indicators and9 secondary indicators.The top three weight coefficients of the secondary indicators were indications and contraindications,gene detection and pretreatment,and the weight coefficients were 0.1280,0.1245 and 0.1205 respectively.Camrelizumab was included in3 primary indicators and 8 secondary indicators,and the first three weight coefficients of the secondary indicators were indications and contraindications,genetic testing and adverse reactions,with coefficients of 0.2685,0.1866 and 0.1503 respectively.All indicators in the case completely met the evaluation criteria and were marked as"A",with a score of 10 points;Those that didn’t meet the requirements completely were marked as"B"and the score is 0.By calculating the approximate value C_ibetween each evaluation object and the optimal scheme,the analysis and collation of relevant data could be completed.The results of the study showed that before rituximab intervention,the total proportion of basically reasonable and reasonable cases was 73.0%,and the proportion of irrational cases was 27.0%.The top three unreasonable rates of single index were:pretreatment before administration was not standard,Inappropriate administration speed,and Inappropriate sequence of combined administration.The total proportion of basically reasonable and reasonable cases in the pre-intervention group of carmelizumab was54.9%,and the proportion of irrational cases was 45.1%.The irrational rates of single index ranked the top three respectively:indications and contraindications,inappropriate dosage and inappropriate combination of drugs.Countermeasures were put forward to rectify the medication problems displayed before rituximab intervention.After rational drug intervention,the proportion of basically reasonable and reasonable cases after rituximab intervention increased to 99.0%,and the proportion of irrational cases decreased to 1.0%,the qualified rate of pretreatment before drug administration in single index increased from 50.0%before intervention to 100.0%after intervention,the qualified rate of drug administration speed increased from 76.0%before intervention to 100.0%after intervention,and the qualified rate of combined drug administration sequence increased from 87.0%before intervention to 99.0%after intervention.The results showed significant differences(p<0.01),and reasonable medication intervention was effective.The research proved that it was feasible to comprehensively evaluate the rationality of new anti-tumor drugs based on AHP-weighted TOPSIS method,and the evaluation results were clearer,more concise and more reliable.This system could also be used in the rational drug use evaluation of other new anti-tumor drugs.There were still some problems in the use of rituximab in the Affiliated Hospital of Qingdao University.After analyzing the problems,and through pharmaceutical training and education,optimization and upgrading of His system and other aspects,after the rectification,patients who used rituximab could be pretreated according to the standard before taking medicine.During use,patrol was strengthened to avoid the situation of excessive dripping speed.When combined with other anti-tumor drugs,rituximab could also be used first according to the specification requirements,and the overall rational drug use situation had been significantly improved.The evaluation results of rational drug use of camrelizumab by the evaluation system were basically consistent with the actual situation.The irrational drug use of camrelizumab found in the evaluation should be paid close attention to and continuously improved in the later period.