Coste J, Séné B, Milstein C, Bouée S, Venot A
Département de Biostatistique et d'Informatique Médicale, Faculté Cochin, Université Paris V, Paris, France.
Methods Inf Med. 1998 Jan;37(1):38-44.
Irrational and inconsistent drug prescription has considerable impact on morbidity, mortality, health service utilization, and community burden. However, few studies have addressed the methodology of processing the information contained in these drug orders used to study the quality of drug prescriptions and prescriber behavior. We present a comprehensive set of quantitative indicators for the quality of drug prescriptions which can be derived from a drug order. These indicators were constructed using explicit a priori criteria which were previously validated on the basis of scientific data. Automatic computation is straightforward, using a relational database system, such that large sets of prescriptions can be processed with minimal human effort. We illustrate the feasibility and value of this approach by using a large set of 23,000 prescriptions for several diseases, selected from a nationally representative prescriptions database. Our study may result in direct and wide applications in the epidemiology of medical practice and in quality control procedures.
不合理和不一致的药物处方对发病率、死亡率、医疗服务利用和社区负担有相当大的影响。然而，很少有研究探讨处理这些用于研究药物处方质量和开处方者行为的药物医嘱中所含信息的方法。我们提出了一套全面的药物处方质量定量指标，这些指标可以从药物医嘱中得出。这些指标是使用明确的先验标准构建的，这些标准先前已根据科学数据得到验证。使用关系数据库系统进行自动计算很简单，这样可以用最少的人力处理大量的处方。我们通过从一个具有全国代表性的处方数据库中选取的23000份针对几种疾病的大量处方来说明这种方法的可行性和价值。我们的研究可能会在医疗实践流行病学和质量控制程序中得到直接和广泛的应用。
