Schwartz J I, Kennedy T J
Am J Hosp Pharm. 1982 Jul;39(7):1198-201.
A computer-assisted practitioner-response system was used to review cimetidine use in one hospital. All patients receiving cimetidine from April 1, 1981, through May 15, 1981, were identified daily using a computerized medication-profile system. A practitioner-response form, which asked the physician to indicate the reason for prescribing cimetidine, was placed in the chart of all patients receiving the drug. When these forms were collected, the reviewer scanned the chart for patient demographic information, duration of cimetidine therapy, and other drugs prescribed that potentially could interact with cimetidine. If the physician did not complete the form, the reviewer checked the chart for prescribing information. Cimetidine was prescribed for 10% (247) of all patients admitted during the study period. Seventy percent of the practitioner-response forms were completed; the indication for cimetidine use was obtained for an additional 20% through chart review. Seventy-five percent of the patients were exposed to a potential drug interaction. The most common reason for prescribing cimetidine was to prevent stress ulcers; only 15% of cimetidine orders were for FDA-approved uses. The computer-assisted practitioner-response system was an efficient method for reviewing cimetidine use. The computerized medication profile facilitated identification of patients receiving the drug, and the practitioner-response form provided the indication-for-use data more quickly than conventional chart review.
采用计算机辅助的医生反馈系统对一家医院西咪替丁的使用情况进行审查。利用计算机化用药记录系统每日确定1981年4月1日至1981年5月15日期间所有接受西咪替丁治疗的患者。在所有接受该药物治疗的患者病历中放置一份医生反馈表,要求医生注明开具西咪替丁的原因。收集这些表格时,审查人员会在病历中查找患者人口统计学信息、西咪替丁治疗时长以及其他可能与西咪替丁相互作用的所开具药物。如果医生未填写表格,审查人员会在病历中查找处方信息。在研究期间入院的所有患者中,10%(247例)开具了西咪替丁。70%的医生反馈表已填写完成;通过病历审查又获得了另外20%的西咪替丁使用指征。75%的患者面临潜在的药物相互作用。开具西咪替丁最常见的原因是预防应激性溃疡;只有15%的西咪替丁医嘱用于美国食品药品监督管理局(FDA)批准的用途。计算机辅助的医生反馈系统是审查西咪替丁使用情况的一种有效方法。计算机化用药记录有助于识别接受该药物治疗的患者,而且医生反馈表比传统病历审查能更快地提供用药指征数据。