Conners Gregory P, Hays Daniel P, Richardson Thomas, Zwemer Frank L
Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY, USA.
Int J Emerg Med. 2009 Dec 11;2(4):251-4. doi: 10.1007/s12245-009-0137-4.
Although adding a drug to an emergency department-based automated medication management system is known to increase how frequently it is ordered, little is known about this effect when the added drug does not offer substantial benefit over a substitute drug that was already available.
We studied the effect of adding nebulized levalbuterol to a pediatric emergency department-based automated medication management system that already included albuterol.
All completed orders for nebulized levalbuterol or nebulized albuterol from our academic pediatric emergency department were retrospectively identified using a computerized pharmacy database. We compared ordering of these drugs for the year before levalbuterol was added to the automated medication management system, during which it was available only from the hospital central pharmacy via a pneumatic tube system, with the year following its inclusion in the system.
There were 6 orders for nebulized levalbuterol and 1,295 orders for nebulized albuterol during the year that levalbuterol was only available from the hospital central pharmacy, and 7 orders for nebulized levalbuterol and 1,108 orders for nebulized albuterol during the year following levalbuterol's inclusion in the automated medication management system. There was no significant difference (p = 0.78).
Use of nebulized levalbuterol, in relation to that of nebulized albuterol, for which it is a substitute, did not significantly change when it was included in the pediatric emergency department automated medication management system. This may reflect the lack of substantial benefit that levalbuterol offers over nebulized albuterol in managing children in the emergency department.
虽然已知在急诊科自动药物管理系统中添加一种药物会增加其被开具的频率，但对于添加的药物相较于已有的替代药物并无显著优势时的这种影响，人们了解甚少。
我们研究了在一个已包含沙丁胺醇的儿科急诊科自动药物管理系统中添加雾化用异丙托溴铵的效果。
利用计算机化药房数据库对我们学术性儿科急诊科所有已完成的雾化用异丙托溴铵或雾化用沙丁胺醇的医嘱进行回顾性识别。我们比较了在异丙托溴铵添加到自动药物管理系统之前的一年（在此期间它仅可通过气动管道系统从医院中心药房获取）以及其被纳入系统后的一年中这些药物的开具情况。
在异丙托溴铵仅可从医院中心药房获取的那一年，有6例雾化用异丙托溴铵的医嘱和1295例雾化用沙丁胺醇的医嘱，而在异丙托溴铵被纳入自动药物管理系统后的那一年，有7例雾化用异丙托溴铵的医嘱和1108例雾化用沙丁胺醇的医嘱。差异无统计学意义（p = 0.78）。
在儿科急诊科自动药物管理系统中纳入雾化用异丙托溴铵后，与作为其替代品的雾化用沙丁胺醇相比，其使用情况并未显著改变。这可能反映出在急诊科治疗儿童时，异丙托溴铵相较于雾化用沙丁胺醇并无显著优势。
