| Summary: | 碩士 === 臺北醫學大學 === 醫學資訊研究所 === 95 === Objectives:
Compared with the first generation antipsychotics, the second generation antip-sychotics were not only less EPS-prone but also the same or more effective for treating schizophrenic patients. They also improved patients’ cognitive function and social function. How to choose between different second generation antip-sychotics? This study constructed a decision support system for prescribing second generation antipsychotics by previous prescription database in hospital information system.
Method:
The pharmacy-prescription database from Taoyuan mental hospital was used and it was further limited to outpatients with the diagnosis of schizophrenia or schi-zoaffective disorder by ICD-9-CM. All patients receiving antipsychotics be-tween 2002 and 2005 were defined as intend-to-treat populations and were fol-lowed for at least one year. Time to discontinuation was the primary outcome. Other factors such as geographic data, past hospitalization history, past drug history…etc were parametered into Cox proportional hazard model for analysis and they were the factors of decision support system.
Result:
Two subsystems were set up finally. The one was “Query for past history” and the other was “Decision support system for antipsychotics prescription”. Totally 11085 treatment episodes were identified during the study period. Age, hospi-talization history, prior use of first generation antipsychotics, prior use of second generation antipsychotics, the duration of prior drug treatment…were statisti-cally significant for time to discontinuation by using Cox proportional hazard regression model and they were used to construct “Decision support system for antipsychotics prescription” subsystem.
Conclusion:
Physicians could get all the information needed to make their decision on antip-sychotics prescription by “Query for past history” subsystem. “Decision support system for antipsychotics prescription” subsystem showed the possible out-comes in the same database after choosing different second generation antipsy-chotics. Both help in clinical setting.
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