临床决策支持系统支持住院老年患者的干预:这是自然过程和适当时机的问题
N A Zwietering1,2, Aemjh Linkens3,4, D Kurstjens5
1Department of Geriatric Medicine, Laurentius Hospital, 6040 AX, Roermond, PO box 920, The Netherlands. anne.zwietering@lzr.nl.
BMC geriatrics
|March 15, 2024
概括
临床决策支持系统 (CDSS) 可以减少住院老年患者的药物相关问题. 大多数CDSS警报在4-5天之间得到解决,这表明有可能优化时间以防止警报疲劳.
科学领域:
- 老年医学 老年医学
- 临床信息学 临床信息学
- 药理学 药理学是指药理学的学科.
背景情况:
- 与药物相关的问题 (DRP) 和潜在的不适当的处方 (PIP) 对患者的结果产生负面影响.
- 临床决策支持系统 (CDSS) 在减少住院老年人中的PIP方面表现有前途.
- 由于诸如临床相关性有限和警觉疲劳等因素,临床医生对CDSS建议的坚持往往很低.
研究的目的:
- 评估CDSS在住院老年患者中的实际使用情况.
- 分析住院第一至第七天的前20个CDSS规则警报的时间进展和干预率.
- 确定特定的CDSS规则是否可以确定最佳干预时间.
主要方法:
- 包括Zuyderland医疗中心所有60岁及以上的住院患者.
- 每天运行CDSS,评估从住院第一到第七天的警报.
- 收集人口和临床数据,包括总警报,前20个规则警报,药剂师干预和警报结果.
主要成果:
- 包括3574名患者 (平均年龄76.7岁,53%为女性),产生8073个警报.
- 排名前20名的规则警报约占所有生成的警报的90%.
- 大多数规则在4-5天之间显示了最高分辨率,不同临床规则的分辨率水平有所不同 (25%至>70%).
结论:
- 该研究跟踪了住院老年患者中20个最常见的CDSS警报.
- 对于大多数规则来说,高峰预警分辨率发生在4-5天之间,而不管药剂师的干预.
- 警报分辨率的变化表明临床相关性的差异,强调需要CDSS优化以减轻警报疲劳.
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