The experience of drug interaction alert system established on a regional hospital

• Main Authors: Fam-min HOU, 侯芳敏
• Other Authors: Han-chuan Yang
• Format: Others
• Language: zh-TW
• Published: 2005
• Online Access: http://ndltd.ncl.edu.tw/handle/57319895254475808987

碩士 === 亞洲大學 === 健康管理研究所 === 94 === Abstract This purpose of this study is to construct a drug interaction alert system for an outpatient Physician Order Entry System, currently executed in an outpatient department, to avoid unwanted side effects due to the reactions of mixing different medicines. From the online records of the reactions among different medicines and the interaction among different doctors in different specialty background, the behaviors of doctors’ prescriptions on medicines can be analyzed. The outcome of a questionnaire indicates that 73.75% of doctors know about the drug interaction alert system applied in this hospital, and 64% of doctors are aware that this drug interaction alert system can help reduce the risks of misusing medicines. Also, 55.2% of doctors confirm that the drug interaction alert system does not interfere their decision making on medicine prescriptions. Further analysis on the outcome of the questionnaire shows that specialty background, age, ranking, and years of practicing are the major factors affecting how a doctor fill in the questionnaire. However, further interviews with doctors confirm that many doctors believe in the necessity of drug interaction alert system. Although many doctors prescribe medicines based on their clinical experiences and data reported in journal articles, misjudgment on the interactions of different medicines happen from time to time. Therefore a drug interaction alert system is appreciated and can offer great help for doctors providing the correct medicine prescriptions to avoid side effects due to medicine interaction. Some medicines do interact when they are mixed. For example, cardiac medicine Digoxin and Nadis are responsible for 2/3 of the first class medicine interaction cases in this hospital. However, this kind of medicine interaction is not dangerous if the medicine is correctly used, and its reaction is intensively monitored. The toxic reaction of Digoxin is closely related to the doses, concentration of ions, and kidney function, which excretes Digoxin outside our bodies. Therefore, when the two medicines are used together, the doses need to be carefully considered according to the conditions of patient’s kidney, and the ion concentration in blood stream needs to be closely monitored. In the meantime, patients need to be well informed and constantly educated to be aware of some critical issues about themselves. Under the above circumstances, this kind of medicine interaction poses no threat to the treatment of a patient. The situations of the first class medicine interaction are most commonly seen among chief doctors. A research result indicates that according to their long-term clinical experiences, an aggressive treatment by continuously prescribing the first class interaction medicine is essential for some patients. However, another questionnaire analysis done one month later reveals that, after some first-class-interaction medicine propaganda, the number of first-class-interaction-medicine prescriptions has been fallen dramatically. This proves that the drug interaction alert system implemented in the outpatient Physician Order Entry System is very helpful to improve doctors’ medicine prescriptions. It is very effective in reducing cases of ill-prescription of medicine and is very important for doctors and patients alike. This system is an essential mechanism to ensure safe use of medicine, which offers great assurance on the correct medicine prescription for patients.