智能化和精确化用药监测软件的研发及应用

The Effect of Developing the Intelligent and Accurate Software of Monitoring on Drug Use

关键词:  智能化用药监测系统  CPM-抗菌药物理想曲线版  禁忌症  诊断  检验值  可预防的药物不良事件

Key words:  intelligent prescription screening system  antibacterial-application software  contraindications  diagnosis  laboratory value  preventable adverse drug events

摘要:

目的 研发智能化和精确化用药监测软件，以减少可预防的药物不良事件的危害。方法 以抗菌药物的药动学和药效动力学理论为基础，成功研发“CPM-抗菌药物理想曲线版”；基于医院信息系统，实现药品说明书中“禁忌症”与患者的病情诊断、检验值相链接，成功研发“智能化用药监测系统”。选择某院呼吸内科为试验组，以另外3家医院呼吸内科为对照组。前14个月2组均不进行干预；后12个月，在试验组中，以“智能化用药监测系统”和“CPM-抗菌药物理想曲线版”审查处方，将审查出的“禁忌症”警示以及抗生素剂量错误定期反馈给医生并进行用药教育，而对照组不进行干预。另外，对2组全部时间段内的各种药物不良事件进行监测。结果 在试验组中，干预前发现可预防的严重药物不良事件38例，发生率为2.7%；进行干预后，用药错误警示及占处方量百分比以2个月时间段计从最高的89例和1.43%下降到最低的27例和0.36%。发现可预防的严重药物不良事件13例，发生率为1.1%，下降有统计学意义。而对照组没有变化。结论 当处方中存在违反“禁忌症”或抗生素剂量错误时，能够分别被“智能化用药监测系统”和“CPM-抗菌药物理想曲线版”识别，并能降低呼吸内科可预防的严重药物不良事件的发生率。

Abstract:

OBJECTIVE To develop the intelligent and accurate software of monitoring on drug use in order to decrease the harmfulness of preventable adverse drug events. METHODS To develop the “antibacterial-application software” successfully basing on pharmacokinetics and pharmacodynamics of antibiotics. To develop “the intelligent prescription screening system” successfully and realize the connection between “contraindications” with diagnosis of patients, their laboratory results basing on the information system of the hospital. Selected the respiratory medicine of a hospital as the experiment group, and the respiratory medicine of the other three hospitals as the contrast group. During the former 14 months, both groups were not intervened. During the latter 12 months, in the experimental group, using “the intelligent prescription screening system” and “antibacterial-application software” to examine prescriptions and returned the “contraindications” or antibacterial dose errors to the doctors and gave the relative education. There were no interventions in the contrast group. In addition, all adverse drug events of the two periods were surveyed. RESULTS In the experimental group, 38 serious preventable adverse drug events were discovered, the incidence was 2.7%. After intervention, medication errors and their percentage to prescriptions were from 89 and 1.43% the most to 27 and 0.36% the least. Thirteen serious preventable adverse drug events were found out, the incidence was 1.1%. The decline rate was evident. There was no change in the contrast group. CONCLUTION When prescriptions in which “contraindications” and antibacterial dose errors are present, they can be found out by the “system” and “antibacterial-application software”, and the incidence of preventable adverse drug events are able to be declined in the respiratory medicine.