在两个卫生系统中对阿片类类似物进行过敏警报和取消优先权
Rachel L Wasserman1,2, Foster R Goss3, Diane L Seger4
1Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA rwasserman@bwh.harvard.edu.
BMJ health & care informatics
|May 25, 2025
概括
超过70%的阿片类药物过敏警报 (DAA) 被覆盖,大多数反应的严重程度低至中等. 重新设计这些警报可以降低覆盖率并提高患者安全.
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
- 医疗信息学 医疗信息学
背景情况:
- 在临床决策支持系统 (CDS) 中,阿片类药物过敏警报 (DAA) 经常被覆盖.
- 很少有研究专注于优化与阿片类药物相关的DAA,以减少警觉疲劳和提高患者安全.
研究的目的:
- 为了确定阿片类同类DAA覆盖的频率.
- 根据患者和提供者类型,记录的过敏反应,严重程度和过敏度来评估覆盖的DAA.
- 为改善与阿片类药物相关的CDS系统提供建议.
主要方法:
- 在两个卫生系统中进行了一项观察性,横截面的研究.
- 数据包括患者人口统计,药物过敏,药物订单,警报覆盖和18岁以上阿片类DAA患者的记录反应.
- 根据反应类型,严重程度 (高,中,低) 和过敏度分析了阿片类类似物过敏症.
主要成果:
- 在超过5万名患者中产生了超过70万种阿片类类似的DAA,覆盖率为71.8%.
- 近四分之三的重置反应是低到中度的严重程度.
- 只有29.3%的覆盖警报是真正的免疫媒介反应.
结论:
- 建议将46.4%的中断性警报转换为非中断性警报,从而有可能将中断性警报减少一半.
- 这些发现突出了通过重新设计DAA来增强与阿片类药物相关的CDS系统的机会.
- 改进DAA设计可以降低覆盖率,对抗警报疲劳,并提高患者安全.
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