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基于临床决策支持系统的干预措施以改善用药效果:关于特征与效果的系统文献综述

Clinical decision support systems-based interventions to improve medication outcomes: A systematic literature review on features and effects.

作者信息

Shahmoradi Leila, Safdari Reza, Ahmadi Hossein, Zahmatkeshan Maryam

机构信息

Health Information Management Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.

OIM Department, Aston Business School, Aston University, Birmingham B4 7ET, United Kingdom.

出版信息

Med J Islam Repub Iran. 2021 Feb 22;35:27. doi: 10.47176/mjiri.35.27. eCollection 2021.

Abstract

Clinical decision support systems (CDSSs) interventions were used to improve the life quality and safety in patients and also to improve practitioner performance, especially in the field of medication. Therefore, the aim of the paper was to summarize the available evidence on the impact, outcomes and significant factors on the implementation of CDSS in the field of medicine. This study is a systematic literature review. PubMed, Cochrane Library, Web of Science, Scopus, EMBASE, and ProQuest were investigated by 15 February 2017. The inclusion requirements were met by 98 papers, from which 13 had described important factors in the implementation of CDSS, and 86 were medicated-related. We categorized the system in terms of its correlation with medication in which a system was implemented, and our intended results were examined. In this study, the process outcomes (such as; prescription, drug-drug interaction, drug adherence, etc.), patient outcomes, and significant factors affecting the implementation of CDSS were reviewed. We found evidence that the use of medication-related CDSS improves clinical outcomes. Also, significant results were obtained regarding the reduction of prescription errors, and the improvement in quality and safety of medication prescribed. The results of this study show that, although computer systems such as CDSS may cause errors, in most cases, it has helped to improve prescribing, reduce side effects and drug interactions, and improve patient safety. Although these systems have improved the performance of practitioners and processes, there has not been much research on the impact of these systems on patient outcomes.

摘要

临床决策支持系统(CDSSs)干预措施被用于改善患者的生活质量和安全性,同时也用于提高从业者的表现,尤其是在药物治疗领域。因此,本文的目的是总结关于CDSS在医学领域实施的影响、结果和重要因素的现有证据。本研究是一项系统的文献综述。截至2017年2月15日,对PubMed、Cochrane图书馆、科学网、Scopus、EMBASE和ProQuest进行了调查。98篇论文符合纳入要求,其中13篇描述了CDSS实施中的重要因素,86篇与药物治疗相关。我们根据系统与实施系统的药物治疗的相关性对系统进行了分类,并检查了我们预期的结果。在本研究中,对过程结果(如处方、药物相互作用、药物依从性等)、患者结果以及影响CDSS实施的重要因素进行了综述。我们发现证据表明,使用与药物治疗相关的CDSS可改善临床结果。此外,在减少处方错误以及提高所开药物的质量和安全性方面也取得了显著成果。本研究结果表明,尽管诸如CDSS之类的计算机系统可能会导致错误,但在大多数情况下,它有助于改善处方,减少副作用和药物相互作用,并提高患者安全性。尽管这些系统提高了从业者的表现和工作流程,但关于这些系统对患者结果的影响的研究并不多。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d23b/8214039/21d1cd85bb38/mjiri-35-27-g001.jpg

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