電子病歷應用在藥物不良反應的通報與防範

目的：隨著病歷逐漸電子化的潮流，針對患者藥物不良反應資料庫應得到更完整的建立，才能讓系統資料庫有充足的患者用藥後不良反應資訊，作為處方提示與臨床用藥的參考，對於提高藥物不良反應的通報也應該被列為優先作為。數據來源：統計中部某醫學中心6個月門診醫師處方患者曾發生藥物不良反應史的藥物時，系統即時提示與紀錄之資料收集。主要觀察指標：警示總計440次，系統警示後醫師仍處方總計118次，佔全部提示次數27％(N=440)；系統警示後醫師未再處方總計156次，佔全部提示次數35％(N=440)；系統警示並嚴禁開立總計53次，佔全部提示次數12％(N=440)，系統警示後醫師降低劑量處方總計113次，佔全部提示次數26％(N=440)。結論：期待電子病歷新思維藉著應用在改善藥物不良反應通報、警示與防範，進而提高醫療人員對高風險藥物認知與管理，使病患能被充分指導高風險藥物使用須知，減少不良反應傷害與降低醫療成本支出等多贏的局面。

關鍵字

藥物不良反應；電子病歷；通報；防範

並列摘要

OBJECTIVE: Medical gradual trend of electronic patient Adverse drug reactions database should be complete establishment, in order to allow the system databases have sufficient information of adverse reactions in patients with medication as prescribed prompt and clinical drug reference, so we think for improving drug-notification of adverse reactions should be a priority as. DATA SOURCES: Statistics a medical center six months outpatient prescription adverse drug reactions have occurred in patients with a history of drugs, the system prompts and record real-time information collected. MAIN OUTCOME MEASURES: Warning of a total of 440 times, after system alert, doctors still prescribe 118 times, 27% (N=440). Who was not prescription 156 times, 35% (N=440). Prescribe was prohibited 53 times, 12% (N=440). To reduce the dose prescription 113 times, 26% (N=440). CONCLUSION: Look forward to the new thinking of the electronic medical record to improve by applying the ADR Bulletin, warning and prevention, thus improving the medical staff on drug awareness and management of high-risk patients can be fully guide high-risk drug use must reduce the harm of adverse reactions and reduce health care costs expenses, and have a good situation.

並列關鍵字

Adverse drug reactions ； Electronic medical record ； reporting ； prevention

參考文獻

1.Bates DW, Cullen DJ, Laird N, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. JAMA : the journal of the American Medical Association 1995;274:29-34.

2.Vora MB, Trivedi HR, Shah BK, Tripathi CB. Adverse drug reactions in inpatients of internal medicine wards at a tertiary care hospital: A prospective cohort study. Journal of pharmacology & pharmacotherapeutics 2011;2:21-5.

3.徐嫦娥. 衛生醫療資訊發展策略地圖之建構－以台灣衛生醫療資訊為例: 臺灣大學; 2005.

4.Coloma PM, Avillach P, Salvo F, et al. A reference standard for evaluation of methods for drug safety signal detection using electronic healthcare record databases. Drug safety : an international journal of medical toxicology and drug experience 2013;36:13-23.

10.李佳津. 藥物警示系統成效及其影響因素之探討－以中部區域醫院為例. 台中市: 中國醫藥大學; 2009.

國際替代計量

電子病歷應用在藥物不良反應的通報與防範

全文下載

主題瀏覽