Bogucki Benjamin, Jacobs Brian R, Hingle John
Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229.
J Am Med Inform Assoc. 2004 Jul-Aug;11(4):278-80. doi: 10.1197/jamia.M1531. Epub 2004 Apr 2.
Medication shortages pose serious problems in health care. This study examines the impact of a computer-based reminder in addressing a national methylprednisolone shortage. An alert was designed and implemented in a computerized order entry platform at a children's hospital. The alert informed physicians of the shortage and provided an alternative prescribing pathway. Data regarding the number and type of parenteral corticosteroid prescriptions were collected for a one-month period before and after the alert was implemented. The alert resulted in a 55% relative reduction in methylprednisolone use and an average reduction of more than three orders each day. Dexamethasone and hydrocortisone, the recommended alternative medications, increased in use by 12% and 49%, respectively. The alert resulted in a $36,552 annualized cost reduction to the institution. Similar alert applications have great potential for effectively altering physician prescribing behavior.
药品短缺给医疗保健带来了严重问题。本研究考察了基于计算机的提醒在应对全国性甲泼尼龙短缺方面的影响。在一家儿童医院的计算机化医嘱录入平台上设计并实施了一项警报。该警报告知医生药品短缺情况，并提供了替代的开药途径。在警报实施前后的一个月时间里，收集了关于胃肠外皮质类固醇处方数量和类型的数据。该警报使甲泼尼龙的使用相对减少了55%，每天平均减少超过三张处方。推荐的替代药物地塞米松和氢化可的松的使用量分别增加了12%和49%。该警报使该机构每年节省了36,552美元的成本。类似的警报应用在有效改变医生开药行为方面具有巨大潜力。
