Delphi Method and Analytic Hierarchy Process to establish an indicator system to evaluate rational drug use in children with primary nephrotic syndrome




Poster session 2


Monday 17 September 2018 - 12:30 to 14:00

All authors in correct order:

Lin M1
1 Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
Presenting author and contact person

Presenting author:

Znb Yva

Contact person:

Abstract text
Nephrotic syndrome (NS) can be divided into three types: primary, secondary and congenital. Primary NS (PNS) accounts for about 90% of instances of NS in children, and is a common childhood glomerular disease. The treatment of children with PNS has been controversial and confused because of hormone tolerance, complications, multiple drug combinations and other issues, but there are no indicators to assess rational drug use (RDU) for children. This study aimed to develop a set of indicators to assess RDU in children with PNS.

Combine the modified Delphi method with an analytic hierarchy process (AHP) to develop a set of indicators to assess RDU in children with PNS, which, subsequently, will be used to verify the actual value.

A systematic search of websites, guidelines and studies was conducted to establish the initial indicators. Then, we carried out a two-round collaborative consensus project using the modified Delphi method among experts in the field of nephrology. We obtained the final indicators by modifying each round based on the comments provided by the experts, and applied the AHP to determine the weight of each indicator.

A consensus was reached after two rounds of the Delphi survey. The final indicators included two first-rank indicators and 16 second-rank indicators, and each indicator was weighted. In round 1 three indicators were modified, two indicators were increased, and six indicators were deleted. In round 2 we reached consensus. The first-rank indicators comprised drug choice (46.96%) and drug usage and dosage (53.04%). The second-rank indicators were aimed at the specific drug therapy. Analysis of the scientific index system showed that the average of the importance and accessibility of the index is > 7, the coefficient of variation is > 0.3, and the coordination coefficient is > 0.4, indicating that experts have a high degree of coordination with the index system and the index is scientific and credible.

We have established the first set indicators to assess RDU of children with PNS. Furthermore, the indicator provides a methodological reference for the development of other indicator sets. We will test the utility of this indicator in further clinical practice.

Patient or healthcare consumer involvement:

Relevance to patients and consumers: 

Children are one of the highest-risk groups that need to monitor rational drug use. Monitoring these indicators will guide people in the absence of drug monitoring indicators to promote the rational use of PNS. Most of the indicators are set according to the guidelines, and other countries and regions can be directly used or modified according to the actual situation. In addition, we also provide a complete method for the development of rational drug use for various diseases.