Bonetto Chiara, Nosè Michela, Barbui Corrado
Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy.
Comput Methods Programs Biomed. 2006 Aug;83(2):120-4. doi: 10.1016/j.cmpb.2006.06.004. Epub 2006 Aug 8.
To develop a methodology for extracting psychotropic drug exposure data from computer-based medical records and for generating drug exposure variables suitable for secondary use.
In South-Verona, Italy, a registry including every patient receiving psychotropic medications is operating since 2004. The basic structure of the registry is the medication record. Each record stores data on a specific prescription, and patients with more than one prescription have more than one record.
The longitudinal history of drug use was described identifying consecutive prescriptions of a specific drug, concomitant prescriptions of a specific drug and distinct prescriptions of a specific drug. Consecutive prescriptions implies that the beginning of the second prescription coincides with the end of the first prescription, concomitant prescriptions implies that the beginning of the second prescription precedes the end of the first prescription, distinct prescriptions implies that a gap of at least 1 day exists between prescriptions. Using this framework of drug representation, we identified episodes of drug therapy, where each episode is constituted of consecutive and/or concomitant prescriptions. Within each episode, prescriptions were categorised into theoretical phases, where the beginning of the new phase always coincides with the end of the previous phase. On the basis of this data representation, a module operating in Access and using Visual Basic for Applications was developed for creating episodes and phases on a routine basis (available from authors). A graphical representation of this conceptual model is presented.
The development of a simple methodology for extracting and generating drug exposure data suitable for secondary use will allow a better understanding of the beneficial and adverse consequences of psychotropic drug use in ordinary practice.
开发一种从基于计算机的医疗记录中提取精神药物暴露数据并生成适合二次使用的药物暴露变量的方法。
在意大利南维罗纳，自2004年起运营一个登记册，其中包括每一位接受精神药物治疗的患者。登记册的基本结构是用药记录。每条记录存储特定处方的数据，有不止一张处方的患者有不止一条记录。
描述了药物使用的纵向历史，确定了特定药物的连续处方、特定药物的联合处方以及特定药物的不同处方。连续处方意味着第二张处方的开始与第一张处方的结束重合，联合处方意味着第二张处方的开始先于第一张处方的结束，不同处方意味着处方之间至少间隔1天。使用这种药物表示框架，我们确定了药物治疗的发作，其中每个发作由连续和/或联合处方组成。在每个发作内，处方被分类为理论阶段，新阶段的开始总是与前一阶段的结束重合。基于这种数据表示，开发了一个在Access中运行并使用Visual Basic for Applications的模块，用于定期创建发作和阶段（可从作者处获取）。给出了这个概念模型的图形表示。
开发一种简单的方法来提取和生成适合二次使用的药物暴露数据，将有助于更好地理解精神药物在常规实践中的有益和不良后果。
