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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。
Objective To develop intelligent and accurate drug monitoring software to reduce the risk of preventable adverse drug events. Methods Based on the pharmacokinetics and pharmacodynamics theory of antimicrobial drugs, the “CPM-Antimicrobial ideal curve” was successfully developed. Based on the hospital information system, the “contraindications” and the patient’s condition Diagnosis, test value link, successfully developed “intelligent drug monitoring system ”. Select a hospital respiratory medicine as the experimental group to another three hospital respiratory medicine as a control group. The first 14 months, the two groups did not intervene; after 12 months, in the experimental group, with “intelligent drug monitoring system” and “CPM-antibacterial ideal curve version” review prescription will be reviewed “Contraindications ” warning and antibiotic dosage error regularly feedback to the doctor and medication education, while the control group did not intervene. In addition, various groups of drug adverse events were monitored over the entire timeframe. Results In the experimental group, 38 cases of preventable serious adverse drug events were found before the intervention, the incidence rate was 2.7%; after the intervention, the error warning and the percentage of prescription taking the maximum of 89 cases in 2-month period 1.43% dropped to the lowest of 27 cases and 0.36%. Thirteen cases of preventable serious adverse drug events were found, the incidence was 1.1%, with a significant decrease. The control group did not change. CONCLUSIONS When prescriptions contain “contraindications” or incorrect dosage of antibiotics, they can be identified by “Intelligent Drug Monitoring System” and “CPM-Antimicrobial Curve”, respectively, and can reduce respiratory medicine The incidence of serious adverse drug events prevented.