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化疗处方临床决策支持系统对化疗过程的影响:系统评价。

Effects of chemotherapy prescription clinical decision-support systems on the chemotherapy process: A systematic review.

机构信息

Department of Health Information Management and Technology, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Division of Pediatric Hematology and Oncology, Department of Pediatrics, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Int J Med Inform. 2019 Feb;122:20-26. doi: 10.1016/j.ijmedinf.2018.11.004. Epub 2018 Nov 17.

Abstract

OBJECTIVE

To carry out a systematic review of studies assessing the effects of chemotherapy prescription clinical decision-support systems (CDSSs) on the chemotherapy process.

METHODS

Articles published in English before May 1, 2017 and indexed in the PubMed and Embase databases were reviewed systematically. Studies that focused on the effects of chemotherapy prescription CDSSs on the chemotherapy process were included in this research and reviewed.

RESULTS

2283 articles were retrieved, of which 37 met the inclusion criteria. Twenty-seven of the included studies reported the effect of chemotherapy prescription CDSSs on medication errors, 18 studies focused on user satisfaction and system acceptance, 10 articles studied the effect of CDSSs on costs and care time and only 3 studies examined the impact on compliance with chemotherapy protocols.

DISCUSSION AND CONCLUSION

In most of the studies, the use of CDSSs in chemotherapy prescription has reduced medication errors, especially dosage errors and has also reduced the time of chemotherapy process takes. However, in a few studies, the system has not been effective in reducing medication errors, has increased certain type of errors or has introduced new errors. Most of the software used has been specifically designed for the chemotherapy process and is intended to increase user satisfaction and system acceptance. There was not sufficient evidence on the effects of these systems on compliance with protocols and chemotherapy costs to draw firm conclusion. Higher quality studies are required to provide more evidence on the effects of CDSSs on medication errors, user satisfaction and system acceptance, costs, care time and compliance with protocols.

摘要

目的

系统评价评估化疗处方临床决策支持系统(CDSS)对化疗过程影响的研究。

方法

系统检索了 2017 年 5 月 1 日前发表在英文文献并被 PubMed 和 Embase 数据库索引的文章。本研究纳入了专注于化疗处方 CDSS 对化疗过程影响的研究,并进行了综述。

结果

共检索到 2283 篇文章,其中 37 篇符合纳入标准。27 项纳入研究报告了化疗处方 CDSS 对用药错误的影响,18 项研究关注用户满意度和系统接受度,10 项研究探讨了 CDSS 对成本和护理时间的影响,仅有 3 项研究考察了对遵守化疗方案的影响。

讨论和结论

在大多数研究中,CDSS 在化疗处方中的应用减少了用药错误,特别是剂量错误,同时也减少了化疗过程的时间。然而,在少数研究中,该系统并没有有效减少用药错误,反而增加了某些类型的错误或引入了新的错误。大多数使用的软件是专门为化疗过程设计的,旨在提高用户满意度和系统接受度。关于这些系统对遵守方案和化疗成本的影响,没有足够的证据得出明确的结论。需要高质量的研究来提供更多关于 CDSS 对用药错误、用户满意度和系统接受度、成本、护理时间和遵守方案影响的证据。

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