改进HIS药学应用基础模块辅助点评乳腺癌术后辅助化疗中抗肿瘤药物合理应用

Improved HIS Pharmacy Application Basic Module in Evaluating Rationality of Antineoplastic Drug in Postoperative Adjuvant Chemotherapy of Breast Cancer

目的通过点评乳腺癌术后辅助化疗方案中抗肿瘤药物临床应用,验证改进后的HIS药学应用基础模块的实用性。方法 HIS药学应用基础模块由具有客户端结构的工作站和工作站应用功能组成。使用信息技术改进后,模块保留原有系统架构,功能扩展:具有临床信息条件筛选、非同源信息共享用户界面和用户操作的功能。用改进模块代替传统人工搜索方法筛选目标病历,对符合纳入条件病历中的抗肿瘤药物医嘱实施人工点评,点评所需信息由改进后的模块提供。进行医嘱点评以检验改进模块的可运行性。结果改进模块筛选出的463份病历,经人工点评后均符合要求。463份病例中使用了TAC、TC和FAC 3个化疗方案,其中使用TAC方案的病历中有29份存在不合理用药,TC方案和FAC方案无不合理用药,点评过程中改进模块提供的信息充分,不需启用其它系统收集信息。结论改进的临床药学模块具有较好的可操作性,可以为抗肿瘤药物医嘱点评提供必要的信息支持。

Objective To comment on the clinical application of antitumor drugs in postoperative adjuvant chemotherapy for breast cancer, and to verify the practicability of the modified pharmacy application basic module in Hospital Information System（HIS）. Methods HIS pharmacy application basic module was composed of client workstation and application function of workstation. After improved by information technology, the module retained the original system architecture, but extended its functions like conditional screening of clinical information, sharing of user interface and user action. Instead of traditional artificial searching method, we applied the modified module to screen target records, then make artificial review on the medical orders which were confirmed to the conditions. The information needed was provided by the improved module. Results The 463 records selected by the improved module were all meet the requirements after manual review. Three chemotherapy regimens（TAC, TC and FAC） were applied in the 463 cases. Among the medical records of TAC regimen, 29 of them had irrational use of antineoplastic drug. But no irrational drug use was found in TC plan or FAC regimens. During the evaluation process, the module has provided sufficient information, and there was no need to use other system to collect information. Conclusion The improved clinical pharmacy module has good maneuverability, and can provide necessary information support for evaluation on rationality of antineoplastic drugs.