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识别预防医院内药物相互作用的有效计算机化策略:一种以用户为中心的方法。

Identifying effective computerized strategies to prevent drug-drug interactions in hospital: A user-centered approach.

作者信息

Missiakos Olivia, Baysari Melissa T, Day Richard O

机构信息

UNSW Medicine, UNSW, Sydney, Australia; Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia.

Centre for Health Systems & Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia; Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia.

出版信息

Int J Med Inform. 2015 Aug;84(8):595-600. doi: 10.1016/j.ijmedinf.2015.04.001. Epub 2015 Apr 13.

Abstract

BACKGROUND

Drug-drug interactions (DDIs) are an important and preventable cause of medication errors in hospitals. Recent developments in technology have seen new strategies emerge for preventing DDIs but these computerized strategies are rarely evaluated and are typically implemented with little input from the individuals using them.

AIM

To determine the opinions of both experts and users (prescribers) on computerized strategies available to assist in the identification and prevention of DDIs in hospitals.

METHOD

Eight drug safety experts and 18 prescribers took part in semi-structured interviews. Participants were asked about their confidence in identifying DDIs and their views on potential computerized strategies to prevent DDIs.

RESULTS

No prescribers reported complete confidence in identifying dangerous DDIs, with junior prescribers appearing less confident than senior prescribers. Most prescribers believed that computerized alerts would be the most effective strategy for preventing DDIs, while experts were more critical of alerts.

CONCLUSION

The lack of confidence displayed by prescribers in their ability to identify DDIs suggests that an appropriate strategy would be one that does not rely on individuals seeking out the information themselves. While a large number of problems related to DDI alert implementation have been reported in the literature (e.g. alert overload), prescribers appeared to be receptive to the idea of being alerted. By ensuring users are aware of the limitations of the system and involving them in DDI strategy design we expect greater use and satisfaction with the adopted strategy.

摘要

背景

药物相互作用(DDIs)是医院用药错误的一个重要且可预防的原因。技术的最新发展催生了预防药物相互作用的新策略,但这些计算机化策略很少得到评估,而且在实施时通常很少有使用这些策略的人员参与。

目的

确定专家和用户(开处方者)对可用于协助识别和预防医院中药物相互作用的计算机化策略的看法。

方法

八位药物安全专家和十八位开处方者参与了半结构化访谈。参与者被问及他们在识别药物相互作用方面的信心以及他们对预防药物相互作用的潜在计算机化策略的看法。

结果

没有开处方者表示对识别危险的药物相互作用完全有信心,初级开处方者似乎比高级开处方者信心更低。大多数开处方者认为计算机化警报将是预防药物相互作用最有效的策略,而专家对警报更为挑剔。

结论

开处方者对自己识别药物相互作用能力缺乏信心,这表明合适的策略应该是不依赖个人自行查找信息的策略。虽然文献中已经报道了大量与药物相互作用警报实施相关的问题(例如警报过载),但开处方者似乎愿意接受被提醒的想法。通过确保用户了解系统的局限性并让他们参与药物相互作用策略设计,我们期望所采用的策略能得到更多使用并提高满意度。

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