对一款合理用药软件审核处方相互作用的效果评估

Evaluation of one rational drug use software for identifying drug-drug interactions in prescriptions

目的:评估北京协和医院使用的合理用药软件在处方审核中关于药物相互作用方面的符合率,为其他医疗机构选择合理用药软件提供参考。方法:随机抽取该院2016年10月3 d的门急诊处方共20 536份,利用合理用药软件药物相互作用审查功能对其进行回顾性分析,并用CCIS数据库网络版"相互作用"查询功能对合理用药软件评价的西药与西药间相互作用的结果进行复核。结果:共有1 578张处方出现3 845次药物相互作用,其中西药与西药间相互作用出现3 372次,西药与中药间相互作用出现473次。CCIS数据库复核显示西药与西药间有相互作用的1272次,与合理用药软件符合率仅37.72%。结论:此款软件是多部门共同论证后选择的比较结合临床工作实际的合理用药软件,但药物相互作用比对结果的符合率提示合理用药软件与实际情况还是存在差距。为了避免误报影响诊疗,最终使临床医生关闭软件运行而失去拦截作用,需要对软件中的专业条目进一步结合临床实际进行优化。

Objective： To assess the accuracy of the rational drug use software for identifying drug-drug interactions（DDIs） in prescriptions in our hospital and provide reference for other hospitals to choose rational drug use softwares. Methods： A total of 20 536 outpatient and emergency prescriptions in October 2016 were randomly sampled and analyzed by rational drug use software for existence of DDIs. The identified DDIs was re-evaluated by utilizing the interaction check function of CCIS database. Results： A total of 3 845 drugdrug interactions were found by the rational drug use software in 1 578 prescriptions, among which 3 372 were between western medicines and western medicines, and 473 were between western medicines and traditional Chinese medicines. CCIS database review showed 1 272 interactions between western medicines and western medicines, and the coincidence rate was 37.72%. Conclusion：The software was chosen by our hospital after comprehensive investigation and discussion of multiple departments and is relatively suitable for clinical practice. However, this study showed there is large gap between the results of DDIs evaluation by the software and the actual situation. Frequent false warnings of existence of DDIs may affect the presecribing of clinicians and make them shut down the software, which will result in the loss of the intervention effect of the software. So it is necessary to optimize the items in the software combined with the actual situation of clinical practice.