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可预防的药物相关发病率指标:在初级保健中的应用

Indicators for preventable drug related morbidity: application in primary care.

作者信息

Morris C J, Rodgers S, Hammersley V S, Avery A J, Cantrill J A

机构信息

School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester M13 9PL, UK.

出版信息

Qual Saf Health Care. 2004 Jun;13(3):181-5. doi: 10.1136/qhc.13.3.181.

Abstract

AIM

To apply in practice a series of validated indicators for preventable drug related morbidity (PDRM).

DESIGN

A pilot study to identify retrospectively potential PDRM events over a 2 year 3 month time frame using the MIQUEST computer software program.

SUBJECTS AND SETTING

The electronic patient record of all patients aged 18 years and over in nine English general practices.

OUTCOME MEASURES

The number of potential PDRM events identified, as defined by the indicators.

RESULTS

Five hundred and seven potential PDRM events were identified from 49 658 electronic patient records, giving an overall incidence of 1.0%. A small number of the indicators (n = 4) accounted for approximately 60% of the events, while for many indicators few events were identified. The most common events related to the use of non-steroidal anti-inflammatory drugs in patients with congestive heart failure or hypertension, lack of monitoring in patients prescribed angiotensin converting enzyme inhibitors, and the use of hypnotic-anxiolytic agents.

CONCLUSIONS

A small number of indicators contributed to the majority of the PDRM events. Interrogation of electronic patient records in primary care using computerised queries shows potential for detecting PDRM.

摘要

目的

将一系列经过验证的可预防药物相关发病(PDRM)指标应用于实践。

设计

一项试点研究,使用MIQUEST计算机软件程序回顾性识别在2年3个月时间范围内的潜在PDRM事件。

研究对象与背景

9家英国全科诊所中所有18岁及以上患者的电子病历。

观察指标

根据指标确定的潜在PDRM事件数量。

结果

从49658份电子病历中识别出507起潜在PDRM事件,总发病率为1.0%。少数指标(n = 4)约占事件总数的60%,而许多指标识别出的事件很少。最常见的事件与充血性心力衰竭或高血压患者使用非甾体抗炎药、开具血管紧张素转换酶抑制剂的患者缺乏监测以及使用催眠抗焦虑药有关。

结论

少数指标导致了大多数PDRM事件。使用计算机查询对初级保健中的电子病历进行审查显示出检测PDRM的潜力。

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