Yu Feliciano, Salas Maribel, Kim Young-Il, Menachemi Nir
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Pharmacoepidemiol Drug Saf. 2009 Aug;18(8):751-5. doi: 10.1002/pds.1777.
This study assesses the impact of computerized physician order entry (CPOE) implementation in pediatric hospitals on reported adverse drug events. Using a nested matched case-control design; we linked CPOE implementation information from the health information management systems society analytics database with reported adverse drug event (ADE) from the national association of children's hospitals and related institutions case mix comparative data program. Differences were examined using univariate and multivariate conditional logistic regression analyses. Patients from CPOE hospitals were more frequently seen in larger hospitals have more co-morbidities than those from non-CPOE hospitals. When matched by admitting diagnosis, age, gender and race, ADE cases were associated with more reported co-morbidities, and were reported less frequently in hospitals with CPOE. Patients from hospitals without CPOE were 42% more likely to experience reportable ADE after adjusting for the presence of co-morbidities. In conclusion, we found significant beneficial associations between reportable ADE and CPOE adoption in a representative sample of pediatric hospitals.
本研究评估了儿科医院实施计算机化医师医嘱录入系统(CPOE)对上报的药物不良事件的影响。采用嵌套匹配病例对照设计,我们将健康信息管理系统协会分析数据库中的CPOE实施信息与全国儿童医院及相关机构病例组合比较数据项目上报的药物不良事件(ADE)相链接。使用单变量和多变量条件逻辑回归分析来检验差异。CPOE医院的患者在大型医院中更常见,比非CPOE医院的患者有更多的合并症。在按入院诊断、年龄、性别和种族匹配后,ADE病例与更多上报的合并症相关,且在实施CPOE的医院中上报频率较低。在调整合并症的存在后,来自未实施CPOE医院的患者发生可上报ADE的可能性高42%。总之,我们在儿科医院的代表性样本中发现可上报ADE与采用CPOE之间存在显著的有益关联。