“智能化用药监控系统”在减少可预防药物不良事件中的作用分析

Effects of the "Intelligent Drug Use Monitoring System" on Decreasing Preventable Adverse Drug Events

目的:为医院减少可预防药物不良事件(ADEs)提供参考。方法:选择某院神经内科、肾脏内科为试验组,以消化内科为对照组。2008年8月1日-2009年7月31日,2组均不进行干预;2009年8月1日-2010年7月31日,在试验组中以自行研发的"智能化用药监控系统"审查处方,将审查出的禁忌证、剂量、频次等用药错误警示定期反馈给医师并进行用药教育,而对照组不进行干预。对2组研究时间段内(2008年8月1日-2010年7月31日)的各种ADEs进行监测。结果:在试验组中,干预前发现可预防ADEs48例,发生率为3.8%,而干预后发现可预防ADEs30例,发生率为1.7%;用药错误警示例数及占处方量百分比以2个月时间段计从最高的378例和2.60%下降到最低的134例和0.91%。其下降均有统计学意义,并因此而节省211662元住院费用,减少了139天住院时间。而对照组相关数据没有显著变化。另外,不可预防的ADEs试验组与对照组干预前、后均没有显著变化。结论:当处方中存在违反禁忌证或剂量、频次等错误时,能够被"智能化用药监控系统"识别,由此可降低医院可预防ADEs的发生率。

OBJECTIVE： To provide reference for reducing preventable adverse drug events （ADEs）. METHODS： We selected the neurology department and nephrology department as the experiment group, and the gastroenterology department as the control group. During Aug. 1st, 2008--Jul. 31st, 2009, both groups were not intervened; During Aug. 1st, 2009-Jul. 31st, 2010, in the experimental group, the ＂intelligent drug use monitoring system＂ was adopted to examine prescriptions and returned the medication errors, such as contraindications, dose, frequency, to the doctors and gave the relative education. There were no interventions in the control group. Various ADEs of two groups were monitored during Aug. 1st, 2008--Jul. 31st, 2010. RESULTS： In the experimental group, 48 preventable ADEs were discovered, and the incidence was 3.8%. After intervention, 30 preventable ADEs were found out, and the incidence was 1.7%. Medication errors and their percentage to prescriptions were decreased from 378 cases the most and 2.60% to 134 cases and 0.91% the least during each two months. There was statistical significance. 211 662 yuan of the extra cost of hospitalization were saved, and 139 days of the length of stay were shortened. There was no significant change in the control group. There was no significant change of unpreventable ADEs in neither groups before and after intervention. CONCLUSION： When contraindications, dose and frequency errors are present in prescriptions, they can be found out by the ＂system＂, and the incidence of preventable ADEs are able to be declined.