Role of clinical decision support system in rational use of antibacterial drugs in primary medical institutions

doi:10.3877/cma.j.issn.1674-0785.2019.07.010

Abstract

Abstract:

Objective

To investigate the feasibility of using the intelligent clinical decision support system (CDSS) based on machine learning technology to regulate the use of antibiotics.

Methods

Five clinics in Chengdu which used the CDSS were selected to collect the outpatient medical records and prescriptions from July 2017 to September 2018. A total of 5128 prescriptions were selected according to the diagnosis. The use of antibacterial drugs before and after the use of CDSS was compared, and the impact of CDSS on the use of antibacterial drugs by primary outpatient doctors was evaluated.

Results

One year after the use of CDSS, the use of antibacterial drugs in outpatient clinics was more standardized. In the treatment of upper respiratory tract infection, the rational use of antibiotics was improved significantly (P<0.05).

Conclusion

CDSS has a good effect in regulating the use of antibacterial drugs in outpatient clinics.

Key words: Clinical decision support system, Anti-bacterial agents, Rationalization

Xinwen Zhang, Yong Tang, Wen Wang. Role of clinical decision support system in rational use of antibacterial drugs in primary medical institutions[J]. Chinese Journal of Clinicians(Electronic Edition), 2019, 13(07): 532-536.

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References 20

[1]	Ferri M, Ranucci E, Romagnoli P, et al. Antimicrobial resistance: A global emerging threat to public health systems [J]. Crit Rev Food Sci Nutr, 2017, 57(13): 2857-2876.
[2]	中华医学会.抗菌药物临床应用指导原则(2015版) [C]//江西省医院协会江西省药事管理质量控制中心. 2015年全国临床药师高峰论坛暨江西省医院药事管理学术年会论文集[C].北京：人民卫生出版社, 2015: 1-7.
[3]	王文杰，肖琳琪，李琛, 等. 我国中西部三省(自治区)贫困边远地区农村基层医疗机构基本药物使用状况 [J]. 中国卫生资源, 2017, 20(6): 490-494.
[4]	沈萍，辛婧媛，吕良, 等. 银川市基层医疗机构抗菌药物使用情况对比分析 [J]. 宁夏医学杂志, 2019, 41(5): 452-454.
[5]	蒋杰，于珊珊，周颖真, 等. 我国抗菌药物滥用现状及对策分析 [J]. 中国医院用药评价与分析, 2018, 18(10): 1307-1308.
[6]	Sim I, Gorman P, Greenes RA, et al. Clinical decision support systems for the practice of evidence-based medicine [J]. J Am Med Inform Assoc, 2001, 8(6): 527-534.
[7]	Schwartz EJ, Bscpharm JT, Bscpharm JP. 世界家庭医生组织(WONCA)研究论文摘要汇编—初级卫生保健中实施标准化药物治疗管理的附加方法 [J]. 中国全科医学, 2018, 21(1): 113.
[8]	姚弥，李楠. 临床决策支持系统对全科医生发展的作用探讨 [J]. 中国全科医学, 2018, 21(10): 1225-1229.
[9]	于启林，刘海一. 医院门诊患者病种调查分析 [J]. 中华医院管理杂志, 2003, 19(7): 55-57.
[10]	刘丽，肖月，张敏, 等. 成都市各级医疗机构主要就诊病种的对应分析 [J].医学与社会, 2018, 31(11):31-33, 49.
[11]	Disease GBD, Injury I, Prevalence C. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 [J]. Lancet, 2018, 392(10159): 1789-1858.
[12]	陆佩琴. 2015~2017年上海某社区卫生服务中心门诊抗菌药物使用情况分析 [J].中国处方药, 2019, 17(3): 48-49.
[13]	Gulliford M, Juszczyk D, Yardley L. What is ″normal″ antibiotic prescribing? [J]. BMJ, 2019, 364: l1144.
[14]	盛谊，刘舒园，田阳. 浅谈对基层抗菌药物使用的全流程监管 [J]. 中国卫生法制, 2019, 27(2): 96-98.
[15]	Dogan M, Mutlu LC, Yilmaz I, et al. Are treatment guides and rational drug use policies adequately exploited in combating respiratory system diseases? [J]. J Infect Public Health, 2016, 9(1): 42-51.
[16]	葛均波，徐永健，王辰, 等. 内科学［M］.北京: 人民卫生出版社, 2018: 14-17, 353.
[17]	缪晓辉，冉陆，张文宏, 等. 成人急性感染性腹泻诊疗专家共识 [J]. 中华消化杂志, 2013, 33(12): 793-802.
[18]	中国医师协会呼吸医师分会，中国医师协会急诊医师分会，林江涛.普通感冒规范诊治的专家共识 [J]. 中国急救医学, 2012, 32(11): 961-965.
[19]	Harris AM, Hicks LA, Qaseem A. Appropriate antibiotic use for acute respiratory tract infection in adults: advice for high-value care from the american college of physicians and the centers for disease control and prevention [J]. Ann Intern Med, 2016, 164(6): 425-434.
[20]	马万兴，朱媛媛，张瑜, 等. 临床决策支持系统应用调查研究 [J]. 医学信息学杂志, 2018, 39(6): 38-42.

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