临床决策支持对处方受控物质的影响
Rachel B Seymour1,2, Meghan K Wally3, Joseph R Hsu3
1Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, 1000 Blythe Boulevard, Charlotte, NC, 28203, USA. Rachel.Seymour@atriumhealth.org.
BMC medical informatics and decision making
|October 20, 2023
概括
临床决策支持 (CDS) 警报影响了处方者的决定,在近五分之一的阿片类药物/二类药物处方中影响了处方者的决定. 这种干预措施有效地促进了遵循指导方针的持续影响和最低限度的处方者疲劳.
科学领域:
- 临床信息学 临床信息学
- 药物监督 药物监督 药物监督
- 医疗保健服务研究 医疗服务研究
背景情况:
- 滥用处方药,特别是阿片类药物和二类药物,构成了重大的公共卫生挑战.
- 临床医生难以获得及时的,相关的患者信息,并与指导方针保持最新.
- 这就需要改进临床决策支持 (CDS) 系统,以帮助处方者.
研究的目的:
- 评估处方者对可能的CDS干预的反应.
- 为了确定患有处方阿片类药物/二二类药物滥用不良事件风险的患者.
- 促进对这些药物的临床实践指南的遵守.
主要方法:
- 从2016年1月到2019年7月,在一个大型的多中心医疗保健系统中进行了一项前性观察研究.
- 通过实施的CDS工具,从电子健康记录中前性收集数据.
- 随着时间的推移,医生对CDS干预措施的反应被评估为61,124,172次涉及阿片类药物/二类药物处方的遭遇.
主要成果:
- 在23.5%的相关遭遇中,CDS警报被触发.
- 在18.1%的警报遭遇中,处方决定受到影响.
- 影响率随着风险因素的增加而增加,并因药物,风险因素,专业和设施而异.
结论:
- 通过CDS提供的基于证据的,针对患者的信息影响了近五分之一的最终处方决定.
- 该干预措施在长时间内证明了可持续性,处方者疲劳最小.
- 在复杂的处方场景中,CDS工具有效地支持遵守指南.
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