Sugawara Tamie, Ohkusa Yasushi, Ibuka Yoko, Kawanohara Hirokazu, Taniguchi Kiyosu, Okabe Nobuhiko
National Institute of Infectious Diseases, Infectious Disease Surveillance Center, Tokyo, Japan.
J Med Internet Res. 2012 Jan 16;14(1):e14. doi: 10.2196/jmir.1881.
Real-time surveillance is fundamental for effective control of disease outbreaks, but the official sentinel surveillance in Japan collects information related to disease activity only weekly and updates it with a 1-week time lag.
To report on a prescription surveillance system using electronic records related to prescription drugs that was started in 2008 in Japan, and to evaluate the surveillance system for monitoring influenza activity during the 2009-2010 and 2010-2011 influenza seasons.
We developed an automatic surveillance system using electronic records of prescription drug purchases collected from 5275 pharmacies through the application service provider's medical claims service. We then applied the system to monitoring influenza activity during the 2009-2010 and 2010-2011 influenza seasons. The surveillance system collected information related to drugs and patients directly and automatically from the electronic prescription record system, and estimated the number of influenza cases based on the number of prescriptions of anti-influenza virus medication. Then it shared the information related to influenza activity through the Internet with the public on a daily basis.
During the 2009-2010 influenza season, the number of influenza patients estimated by the prescription surveillance system between the 28th week of 2009 and the 12th week of 2010 was 9,234,289. In the 2010-2011 influenza season, the number of influenza patients between the 36th week of 2010 and the 12th week of 2011 was 7,153,437. The estimated number of influenza cases was highly correlated with that predicted by the official sentinel surveillance (r = .992, P < .001 for 2009-2010; r = .972, P < .001 for 2010-2011), indicating that the prescription surveillance system produced a good approximation of activity patterns.
Our prescription surveillance system presents great potential for monitoring influenza activity and for providing early detection of infectious disease outbreaks.
实时监测是有效控制疾病暴发的基础，但日本官方的哨点监测仅每周收集一次与疾病活动相关的信息，且更新存在1周的时间滞后。
报告2008年在日本启动的一项利用与处方药相关的电子记录的处方监测系统，并评估该监测系统在2009 - 2010年和2010 - 2011年流感季节监测流感活动的情况。
我们通过应用服务提供商的医疗理赔服务，利用从5275家药店收集的处方药购买电子记录开发了一个自动监测系统。然后将该系统应用于监测2009 - 2010年和2010 - 2011年流感季节的流感活动。该监测系统直接自动地从电子处方记录系统收集与药物和患者相关的信息，并根据抗流感病毒药物的处方数量估算流感病例数。然后它每天通过互联网与公众分享与流感活动相关的信息。
在2009 - 2010年流感季节，处方监测系统估算的2009年第28周和2010年第12周期间的流感患者数量为9234289人。在2010 - 2011年流感季节，2010年第36周和2011年第12周期间的流感患者数量为7153437人。估算的流感病例数与官方哨点监测预测的病例数高度相关（2009 - 2010年：r = 0.992，P < 0.001；2010 - 2011年：r = 0.972，P < 0.001），表明处方监测系统很好地近似了活动模式。
我们的处方监测系统在监测流感活动和早期发现传染病暴发方面具有巨大潜力。
