CN113593724A - Anticoagulant drug treatment management follow-up system - Google Patents
Anticoagulant drug treatment management follow-up system Download PDFInfo
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- G—PHYSICS
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- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H70/00—ICT specially adapted for the handling or processing of medical references
- G16H70/40—ICT specially adapted for the handling or processing of medical references relating to drugs, e.g. their side effects or intended usage
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Abstract
The invention relates to the technical field of medical data processing systems, in particular to an anticoagulant drug treatment management follow-up system which comprises a patient basic information data acquisition module, a medication evaluation module, a problem and evaluation module, a medication plan module, a doctor end, a pharmacist end and a patient end. By adopting the system provided by the invention, the working efficiency of medical staff is improved, analysis and suggestion are carried out according to the medication condition of the patient, the safety of the patient when the anticoagulant drug is used is enhanced, the medication of the patient is standardized, the medical staff can conveniently know the medication condition of the patient in time, and the occurrence of adverse events of the drug is reduced.
Description
Technical Field
The invention relates to the technical field of medical data processing systems, in particular to an anticoagulant drug treatment management follow-up system.
Background
Venous Thromboembolism (VTE), including Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE), has an estimated 100 million people affected per year in the united states and approximately 1/3 relapse within 10 years, although the exact incidence of VTE is unclear. VTEs can be implicated in both hospitalized and non-hospitalized patients and lead to long-term complications including post-thrombotic syndrome (PTS) of thrombotic DVT, chronic thromboembolic pulmonary hypertension, and death.
With the improvement of medical level, the diagnosis rate of DVT and PE is continuously improved, in 2019, the Chinese venous thrombosis research group carries out large-scale multi-center retrospective research, in the ten years from 2007 to 2016, 828 inpatients in 90 hospitals in China are counted, the inpatient rate of VTE patients in 90 hospitals is increased from 3.2/10 ten thousand to 17.5/10 ten thousand, and the current data is far lower than the morbidity of western countries. The current diagnosed incidence of VTE patients in China may be far below the true incidence, which is associated with the inability to effectively identify a large number of VTE patients. With the increasing level of medical and health services, the development of testing equipment and technology, and the understanding and appreciation of diseases by doctors, the VTE incidence will be further increased.
In the treatment of VTE, an anticoagulant drug is usually used, and although the anticoagulant drug has a good efficacy in the treatment process, the inventors have found that at present, the treatment using the anticoagulant drug has disadvantages, particularly:
medical staff, patients and family members have weak anticoagulation consciousness, and poor anticoagulation treatment effect can be caused by the non-standard use of anticoagulation medicines, weak compliance of patients and the like when the patients with venous thromboembolism are treated; the traditional oral medicine warfarin needs to regularly detect coagulation indexes such as INR and the like, needs professionals to guide the administration method of warfarin, and is easily influenced by food, other medicines and patient genes; the dose-effect relationship of the novel oral anticoagulant is definite, but the interaction of the medicines and the influence of the liver and kidney functions also exist; heparin-induced thrombocytopenia may occur with heparin-like drugs and some special cases require investigation of anti-Xa factor and adjustment of drug dose. Therefore, the patient is generally at risk due to insufficient or excessive dosage of the anticoagulant drug, and the patient needs to follow up the safety of the anticoagulant drug for a long time after discharge; when a patient suffers from multiple chronic diseases at the same time, multiple medication increases the risk of interaction between the drugs and increases the occurrence of adverse drug events.
In view of the above problems, there is a need to design a follow-up system capable of targeting anticoagulant drugs for a long time.
Disclosure of Invention
The invention aims to: aiming at the defect that the existing anticoagulant drug treatment using anticoagulant drug has risks in use, a follow-up system which can take the anticoagulant drug as a target drug for a long time is provided.
In order to achieve the above purpose, the invention provides the following technical scheme:
an anticoagulant drug treatment management follow-up system comprises a patient basic information data acquisition module, a medication evaluation module, a question and evaluation module, a medication plan module, a doctor end, a pharmacist end and a patient end.
Preferably, the patient basic information data acquisition module comprises: a hospital data retrieval submodule; and an out-of-hospital data entry submodule.
Preferably, the hospital data retrieval submodule is used for obtaining patient information from the hospital database, wherein the patient information comprises basic information, health information and hospital treatment records.
Preferably, the basic information includes at least the age, sex, identification number of the patient.
Preferably, the health information at least comprises information of other diseases suffered by the patient at present and medication contraindication information.
Preferably, the information on the other diseases at least includes names of other diseases currently suffered by the patient, and treatment protocols adopted for the respective other diseases, in particular, drug protocols adopted in the treatment protocols.
Preferably, the medication contraindication information includes patient contraindications for the medication.
Preferably, the in-hospital treatment record includes at least the time of the in-hospital visit, the office of the visit, the examination results, the diagnosis results, and the medication regimen information.
Preferably, the out-of-hospital data entry sub-module enters the patient's visit out of the hospital.
Preferably, the out-of-hospital data entry module comprises an image recognition entry module and a manual entry module.
Preferably, the image recognition and entry module is used for recognizing and entering image information such as medical orders, examination and examination results, medication schemes and the like generated in the out-of-hospital visit.
Preferably, the patient takes a picture of the order, the examination result and the medication scheme outside the patient's hospital through a camera device at the patient end, and performs OCR recognition and entry on the obtained picture.
Preferably, the manual entry module is used for manually correcting data which cannot be identified or is identified with errors in the image identification entry by the patient, and particularly, correcting whether units of the data outside the hospital are consistent with those inside the hospital or not.
Compared with the prior art, the scheme has the advantages that: the system provided by the invention also comprises a patient basic information data acquisition module, and the data related to the patient is gathered by acquiring the patient basic information data, so that medical personnel can check the related information of the patient more conveniently and can fully master information such as other diseases, medication contraindications, and extra-hospital treatment information of the patient. On one hand, the medical staff can be prevented from calling and checking data from different systems and databases, and the working efficiency of the medical staff is improved; on the other hand, the method is favorable for comprehensively mastering the condition of the patient and avoiding misdiagnosis. In addition, the data outside the hospital is input in the mode of image identification and manual input, so that the input efficiency of the data outside the hospital is improved, and the burden of medical personnel is reduced.
Preferably, the medication evaluation module comprises: a drug reforming list submodule; a clinical examination and examination information acquisition submodule; a liver and kidney function submodule; a medication warning submodule; a drug interaction submodule; a comprehensive assessment dosing regimen sub-module.
Preferably, the drug reforming list sub-module is used for acquiring and integrating the current medication scheme of the patient inside and outside the hospital to form an initial drug reforming list.
Preferably, the list of initial drug reformulations includes: list of other drug reformulations; list of anticoagulant drug reformulations.
Preferably, the reforming method of the other drug reforming list is as follows: for other disease regimens that patients have long used, the last dose is tabulated for other drug reformulations.
Preferably, the reforming method of the reforming list of the anticoagulant drugs is as follows: for the medicines related to the hospital internal medicine scheme or the hospital external medicine scheme, the medicines are directly listed in the final reforming scheme; the drugs involved in both the hospital medication regimen and the hospital medication regimen are listed in the anticoagulant drug reconstitution list in the last dose administered.
Compared with the prior art, the scheme has the advantages that: comprehensively reforming the conditions of the patients for in-hospital and out-hospital external use, on one hand, the current medication conditions of the patients are more comprehensively known, and a foundation is provided for the subsequent process; on the other hand, the anticoagulant drug is deeply researched and arranged for the patient, so that the method is beneficial to reference for the medication methods of other hospitals and is beneficial to optimizing the final medication scheme. In addition, with the particular reformulation methods proposed by the present invention, the same drug is included in the reformulation regimen at the last dose, allowing the reformulation regimen to better match the patient's progress.
Preferably, the clinical examination information acquisition sub-module is used for summarizing the clinical examination information of the patients.
Preferably, the following information is aggregated: checking and checking results in the hospital data calling submodule; and the inspection and inspection results are input by the out-of-hospital data input sub-module.
Preferably, the hepatorenal function submodule is for: and measuring the liver and kidney function level of the patient by combining the clinical examination data and the collected data of the basic information of the patient. Preferably, the renal function grade is calculated by adopting a creatinine clearance calculation formula, and the renal function grade of the patient is judged according to an interval where the calculation result is located. Preferably, the patient's liver function level is determined using the Child-Pugh stratification criteria.
Compared with the prior art, the scheme has the advantages that: in the treatment process, the use of the medicine for patients with liver and kidney insufficiency is strictly limited. In the liver and kidney function submodule, the grade of the comparison of the liver and kidney function score of the patient is calculated by clinical examination and examination data and acquired data combined with basic information of the patient, so that a proper medicine can be used according to the liver and kidney function condition of the patient in the subsequent step, and the occurrence of adverse events of the medicine is reduced.
Preferably, the medication warning submodule is used for warning the treatment scheme of the patient, and the warning comprises an anticoagulant medication scheme forbidden identifier, a medication risk decrement-requiring identifier, a medication risk increment-requiring identifier and problem-free warning information of the current treatment scheme.
Preferably, the medication warning sub-module comprises a support database and a warning judgment sun module.
Preferably, the support database includes suggested values for anticoagulant use for different patients.
Preferably, the warning decision sun module is configured to: respectively acquiring patient information given by two submodules, namely a sub-module and a liver and kidney function sub-module according to clinical examination and examination information, inquiring a support database, judging whether the drugs in an anticoagulant drug reforming list are forbidden, whether drug treatment risks need to be reduced or not and whether drug treatment risks need to be increased or not, if so, prompting that the drug use risks exist, and giving a suggested value according to the support database; if the three problems do not exist, the conclusion that the current treatment scheme has no problem is given.
Preferably, for the convenience of distinguishing, different colors are used for prompting, wherein red is forbidden for the current anticoagulant drugs, yellow is used for prompting that the drug treatment risk needs to be reduced, and brown is used for prompting that the drug treatment risk needs to be increased. Blue is a temporary problem with current treatment regimens.
Compared with the prior art, the scheme has the advantages that: set up on the evaluation module of using medicine and use medicine and warn, judge through the medicine information to the patient, form the warning of using medicine, distinguish anticoagulant drug treatment scheme forbidden item through different signs, there is the drug treatment risk and need reduce the volume item, there is drug treatment risk and need add the volume item and present treatment scheme problem-free item, thereby make medical personnel and patient can clearly whether current anticoagulant drug uses rationally and whether need add volume or decrement, the risk of patient in anticoagulant drug treatment has been reduced, the rationality of prescription has been increased.
Preferably, the drug interaction submodule comprises the following modules: a drug interaction database; and an interaction judging grandchild module.
Drug interaction database: used for storing the interaction information of the anticoagulant medicament and other medicaments.
Preferably, the drug interaction database specifies the magnitude of the drug interaction.
Preferably: the magnitude of drug interactions is divided into four categories of risk according to the outcome of the interaction: contraindication and forbidding combination, otherwise, the effectiveness and the safety are seriously influenced; severe, if necessary, careful combination, moderate effects on effectiveness and safety; moderate, can be combined, slightly affects effectiveness and safety; slight, can be combined together, and does not influence the effectiveness and the safety.
The interaction judging module is used for: and judging whether the medicines in the anticoagulation medicine reforming list have interaction with the medicines in the other medicine reforming list which is taken by the patient due to other diseases or not and the magnitude of the interaction according to the medicine interaction database. I.e. to determine which of the four classes of risk the interaction belongs to.
Compared with the prior art, the scheme has the advantages that: the module judges the interaction between the anticoagulant and other medicines used by the patient, so that the medicines which have the interaction with the anticoagulant and the medicines which do not have the interaction with the anticoagulant are distinguished, and further, whether the medicines in the initial anticoagulant reforming list have the interaction with the medicines which are taken by the patient due to other diseases or not and the size of the interaction are determined. When facing a patient using a plurality of medicines, a pharmacist can fully consider the interaction relation between the medicines for anticoagulation treatment and the medication method which is taken by the patient due to other diseases in the process of determining the final medication scheme, so that scientific guidance is provided for the final decision of the pharmacist, and the occurrence of adverse events of the medicines is greatly reduced.
Preferably, the comprehensive assessment dosing regimen sub-module comprises: an adjustment submodule and a pharmacist confirmation submodule.
Preferably, the adjustment submodule is configured to: and adjusting the anticoagulant reforming list submodule according to the medication warning submodule. Specifically, the current anticoagulant reforming list submodule is adjusted according to the warning information and the suggested value given by the medication warning submodule to form an adjusted medication scheme.
Preferably, the pharmacist validation submodule is operable to: forming the final medication.
Preferably, in the pharmacist confirmation submodule, the medication scheme before adjustment, the medication scheme after adjustment, the warning information formed by the medication warning submodule, and the judgment result of the interaction judgment grandchild module are transmitted to the pharmacist side, and the pharmacist determines the final comprehensive medication scheme after adjustment and determination are performed according to the information.
Preferably, the general medication regimen includes the names of the drugs, the dosage of the drugs, the frequency of use of the drugs, the care of life and food contraindications for the use of the medication regimen.
Compared with the prior art, the scheme has the advantages that: by adopting the medication scheme determination scheme provided by the comprehensive evaluation medication scheme submodule, on one hand, the medication scheme is more suitable for the state of illness and physical condition of the patient, and on the other hand, whether the medication scheme conflicts with other medicines taken by the patient is fully considered, so that the finally obtained medication scheme is more optimal. In addition, the administration scheme comprehensive evaluation submodule can provide sufficient reference information for a pharmacist, so that the time required by the pharmacist for determining the administration scheme is greatly reduced, and the efficiency is improved.
Preferably, the question and evaluation module comprises a medication analysis sub-module, a feedback sub-module and a summary sub-module.
Preferably, the medication analysis submodule is used for comparing and analyzing the anticoagulant drug reforming list and the comprehensive medication scheme and forming a specific analysis report.
Preferably, the specific analysis report includes: the list of anticoagulation drug reformulations lists the change in the dosage of each drug compared to the final dosage regimen.
Preferably, the specific analysis report further comprises: the dosage of various medicines varies.
Preferably, the specific analysis report is formed by using a comparative analysis table.
Preferably, the feedback sub-module sends the specific analysis report to the physician through the physician side.
Preferably, the summarization sub-module uploads the specific analysis report to an analysis report summarization database for summarization.
Compared with the prior art, the scheme has the advantages that: by feeding back a specific analysis report to the physician, the physician can be made aware of the final medication scheme, which facilitates the physician to improve the level. Secondly, specific analysis reports of each time are collected through the collection submodule, so that defects in the medication process can be conveniently and regularly cleared up, and a systemic medication suggestion is formed.
Preferably, the medication plan module comprises: a personal medication plan sub-module; a food contraindication event submodule; a life notice sub-module; and a medicine monitoring plan sub-module.
Preferably, the personal medication plan sub-module is configured to communicate the integrated medication regimen determined in the medication evaluation module to the patient.
Preferably, the medication regimen determined in the comprehensive assessment dosing regimen sub-module is communicated to the patient on the patient side.
Preferably, the food contraindication sub-module is adapted to inform the patient of food precautions during administration.
Preferably, the patient is informed of food contraindications determined in the comprehensive assessment dosing regimen sub-module via the patient side.
Preferably, the event of life sub-module is used to notify the patient of events that should be taken care of during the medication period.
Preferably, the patient is informed of the life precautions determined in the integrated assessment dosing regimen sub-module via the patient side.
Preferably, the medication monitoring planning sub-module comprises a checking inspection item informing grandchild module and a treatment scheme adjusting grandchild module.
Preferably, the inspection item informing module informs the patient of the name and frequency of the inspection item to be inspected through the patient side and informs the monitoring item of the normal range.
Preferably, in the treatment plan adjusting module, after finding that the examination result of the item to be monitored exceeds the normal threshold, the patient side uploads the abnormal index, and the physician/pharmacist obtains the abnormal index through the physician side/pharmacist side, adjusts the medication plan, and updates the adjusted medication plan in the personal medication plan sub-module.
Compared with the prior art, the scheme has the advantages that: the drug monitoring plan submodule provided by the invention is beneficial to evaluating the medication condition and the medication effect of a patient, is convenient for medical staff to adjust the dosage of the anticoagulant drug according to the condition of the patient, and further reduces the risk of the patient caused by insufficient or excessive dosage of the anticoagulant drug.
Preferably, the physician side is used for the physician to upload information to the system and receive relevant information from the system.
Preferably, the pharmacist side is used for the pharmacist to upload information to the system and receive relevant information from the system.
Preferably, the patient side is used for the patient to upload information to the system and to receive relevant information from the system.
Compared with the prior art, the invention has the beneficial effects that:
(1) the system provided by the invention comprises a patient basic information data acquisition module, and the data related to the patient is gathered by acquiring the patient basic information data, so that medical personnel can check the related information of the patient more conveniently, and can fully master information such as other diseases, medication contraindications, and extra-hospital treatment information of the patient. On one hand, the medical staff can be prevented from calling and checking data from different systems and databases, and the working efficiency of the medical staff is improved; on the other hand, the method is favorable for comprehensively mastering the condition of the patient and avoiding misdiagnosis. In addition, the data outside the hospital is input in the mode of image identification and manual input, so that the input efficiency of the data outside the hospital is improved, and the burden of medical personnel is reduced.
(2) The medicament reforming list submodule is adopted to carry out comprehensive reforming on the condition of in-hospital and out-hospital external medicament of a patient, so that on one hand, the current medicament using condition of the patient is more comprehensively known, and a basis is provided for the subsequent process; on the other hand, the anticoagulant drug is deeply researched and arranged for the patient, so that the method is beneficial to reference for the medication methods of other hospitals and is beneficial to optimizing the final medication scheme. In addition, for the same drug, the reforming regimen is included with the last dose so that the reforming regimen can be more consistent with the patient's progress.
(3) In the liver and kidney function submodule, the grade of the comparison of the liver and kidney function score of the patient is calculated by clinical examination and examination data and acquired data combined with basic information of the patient, so that a proper medicine can be used according to the liver and kidney function condition of the patient in the subsequent step, and the occurrence of adverse events of the medicine is reduced.
(4) The medication warning submodule is used for warning a treatment scheme of a patient, medication information of the patient is judged to form medication warning, contra-used items of an anticoagulant medication scheme are distinguished through different identifications, a medication risk item is required to be reduced, a medication risk item is required to be added and an existing treatment scheme is problem-free, so that whether the existing anticoagulant medication is reasonably used or not and whether the anticoagulant medication needs to be added or reduced or not can be clearly seen by medical workers and the patient, risks of the patient in anticoagulant medication are reduced, and the reasonability of a prescription is improved.
(5) The drug interaction submodule judges the interaction between the anticoagulant and other drugs, so that the drugs with the interaction with the anticoagulant and the drugs without the interaction with the anticoagulant are distinguished, and further, whether the drugs in the initial anticoagulant reforming list have the interaction with the drugs which are taken by the patient due to other diseases or not and the magnitude of the interaction are determined. When facing a patient using a plurality of medicines, a pharmacist can fully consider the interaction relation between the medicines for anticoagulation treatment and the medication method which is taken by the patient due to other diseases in the process of determining the final medication scheme, so that scientific guidance is provided for the final decision of the pharmacist, and the occurrence of adverse events of the medicines is greatly reduced.
(6) By adopting the medication scheme determination scheme provided by the comprehensive evaluation medication scheme submodule, on one hand, the medication scheme is more suitable for the state of illness and physical condition of the patient, and on the other hand, whether the medication scheme conflicts with other medicines taken by the patient is fully considered, so that the finally obtained medication scheme is more optimal. In addition, the sub-module for comprehensively evaluating the medication scheme can greatly reduce the time required by a pharmacist to determine the medication scheme and improve the efficiency.
(7) The question and evaluation module can make the doctor know the final medication scheme by feeding back a specific analysis report to the doctor, so that the doctor can conveniently improve the level. Secondly, specific analysis reports of each time are collected through the collection submodule, so that defects in the medication process can be conveniently and regularly cleared up, and a systemic medication suggestion is formed.
(8) The drug monitoring plan submodule provided by the invention is beneficial to evaluating the medication condition and the medication effect of a patient, is convenient for medical staff to adjust the dosage of the anticoagulant drug according to the condition of the patient, and further reduces the risk of the patient caused by insufficient or excessive dosage of the anticoagulant drug.
Description of the drawings:
FIG. 1 is a schematic diagram of an anticoagulant medication management follow-up system;
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be described clearly and completely with reference to the accompanying drawings. It is to be understood that the embodiments described are only a few embodiments of the present invention, and not all embodiments.
Thus, the following detailed description of the embodiments of the invention is not intended to limit the scope of the invention as claimed, but is merely representative of some embodiments of the invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
It should be noted that the embodiments of the present invention and the features and technical solutions thereof may be combined with each other without conflict.
It should be noted that: like reference numbers and letters refer to like items in the following figures, and thus, once an item is defined in one figure, it need not be further defined and explained in subsequent figures.
An anticoagulant drug treatment management follow-up system comprises a patient basic information data acquisition module, a medication evaluation module, a question and evaluation module, a medication plan module, a doctor end, a pharmacist end and a patient end.
Preferably, the patient basic information data acquisition module comprises: a hospital data retrieval submodule; and an out-of-hospital data entry submodule.
Preferably, the hospital data retrieval submodule is used for obtaining patient information from the hospital database, wherein the patient information comprises basic information, health information and hospital treatment records.
Preferably, the basic information includes at least the age, sex, identification number of the patient.
Preferably, the health information at least comprises information of other diseases suffered by the patient at present and medication contraindication information.
Preferably, the information on the other diseases at least includes names of other diseases currently suffered by the patient, and treatment protocols adopted for the respective other diseases, in particular, drug protocols adopted in the treatment protocols.
Medication contraindication information includes patient contraindications for medications.
The hospital treatment record at least comprises the time of the hospital visit, the clinic visit, the examination and examination result, the diagnosis result and the medication scheme information.
Preferably, the out-of-hospital data entry sub-module enters the patient's visit out of the hospital.
Preferably, the out-of-hospital data entry module comprises an image recognition entry module and a manual entry module.
The image recognition and entry module is used for recognizing and entering image information such as medical orders, examination and inspection results, medication schemes and the like generated in the out-of-hospital treatment.
Preferably, the patient takes a picture of the order, the examination result and the medication scheme outside the patient's hospital through a camera device at the patient end, and performs OCR recognition and entry on the obtained picture.
The manual entry module is used for manually correcting data which cannot be identified or is identified with errors in image identification entry by a patient, and particularly correcting whether units of data outside a hospital are consistent with those inside the hospital or not.
Compared with the prior art, the scheme has the advantages that: the system provided by the invention also comprises a patient basic information data acquisition module, and the data related to the patient is gathered by acquiring the patient basic information data, so that medical personnel can check the related information of the patient more conveniently and can fully master information such as other diseases, medication contraindications, and extra-hospital treatment information of the patient. On one hand, the medical staff can be prevented from calling and checking data from different systems and databases, and the working efficiency of the medical staff is improved; on the other hand, the method is favorable for comprehensively mastering the condition of the patient and avoiding misdiagnosis. In addition, the data outside the hospital is input in the mode of image identification and manual input, so that the input efficiency of the data outside the hospital is improved, and the burden of medical personnel is reduced.
Preferably, the medication evaluation module comprises: a drug reforming list submodule; a clinical examination and examination information acquisition submodule; a liver and kidney function submodule; a medication warning submodule; a drug interaction submodule; a comprehensive assessment dosing regimen sub-module.
Preferably, the drug reforming list sub-module is configured to obtain and integrate the current medication regimen of the patient in and out of the hospital to form an initial drug reforming list, wherein the initial drug reforming list comprises: list of other drug reformulations; list of anticoagulant drug reformulations.
Preferably, the reforming method of the other drug reforming list is as follows: for other disease regimens that patients have long used, the last dose is tabulated for other drug reformulations.
Preferably, the reforming method of the reforming list of the anticoagulant drugs is as follows: for the medicines related to the hospital internal medicine scheme or the hospital external medicine scheme, the medicines are directly listed in the final reforming scheme; the drugs involved in both the hospital medication regimen and the hospital medication regimen are listed in the anticoagulant drug reconstitution list in the last dose administered. For example, for a patient a with both hypertension and venous thromboembolism, the regimen for the patient a's hypertension is: medicine A (2 mg) and medicine B (1 mg). The hospital anticoagulant medication plan aiming at the patients' nail vein thromboembolism comprises a medicine C (dosage is 2mg) and a medicine D (dosage is 3mg), and the set time of the medication plan is 2021 year, 8 months and 2 days; the out-of-hospital anticoagulation medication plan aiming at the venous thromboembolism comprises a medicine C (dosage 1mg), a medicine D (dosage 4mg) and a medicine E (dosage 1mg), and the preparation time of the medication plan is 2021 year, 7 months and 5 days. The list of other drug reformulations after reforming is: medicine A (2 mg), medicine B (1 mg); the reformed anticoagulant drug is tabulated as drug C (2 mg dose), drug D (3 mg dose), and drug E (1 mg dose).
Compared with the prior art, the scheme has the advantages that: comprehensively reforming the conditions of the patients for in-hospital and out-hospital external use, on one hand, the current medication conditions of the patients are more comprehensively known, and a foundation is provided for the subsequent process; on the other hand, the anticoagulant drug is deeply researched and arranged for the patient, so that the method is beneficial to reference for the medication methods of other hospitals and is beneficial to optimizing the final medication scheme. In addition, with the particular reformulation methods proposed by the present invention, the same drug is included in the reformulation regimen at the last dose, allowing the reformulation regimen to better match the patient's progress.
Preferably, the clinical examination information acquisition sub-module is used for summarizing the clinical examination information of the patients.
Preferably, the following information is aggregated: checking and checking results in the hospital data calling submodule; and the inspection and inspection results are input by the out-of-hospital data input sub-module.
Preferably, the hepatorenal function submodule is for: and measuring the liver and kidney function level of the patient by combining the clinical examination data and the collected data of the basic information of the patient. Specifically, the renal function grade is calculated by adopting a creatinine clearance calculation formula, and the renal function grade of the patient is judged according to the interval of the calculation result. The patient liver function grade was determined using the Child-Pugh grading criteria.
Compared with the prior art, the scheme has the advantages that: in the treatment process, the use of the medicine for patients with liver and kidney insufficiency is strictly limited. In the liver and kidney function submodule, the grade of the comparison of the liver and kidney function score of the patient is calculated by clinical examination and examination data and acquired data combined with basic information of the patient, so that a proper medicine can be used according to the liver and kidney function condition of the patient in the subsequent step, and the occurrence of adverse events of the medicine is reduced.
Preferably, the medication warning submodule is used for warning the treatment scheme of the patient, and the warning comprises an anticoagulant medicament forbidden identifier, a medicament treatment risk decrement identifier, a medicament treatment risk increment identifier and a current treatment scheme problem-free identifier.
Preferably, the medication warning sub-module comprises a support database and a warning judgment sun module.
Preferably, the support database includes suggested values for anticoagulant use for different patients. Schematically, taking the blood pressure situation as an example: for systolic pressure<For a 90mmHg patient, the suggested value for anticoagulant K is K1-k2(ii) a For 90mmHg<Systolic pressure<For a patient of 140mmHg, the suggested value of anticoagulant K is K3-k4(ii) a For 140mmHg<Systolic pressure<For 160mmHg patients, the suggested value of anticoagulant K is K5-k6For systolic blood pressure>Anticoagulant K is prohibited in patients with 160 mmHg. The above description is merely exemplary in nature and is not intended to limit the present disclosure.
Preferably, the warning decision sun module is configured to: respectively acquiring patient information given by two submodules, namely a sub-module and a liver and kidney function sub-module according to clinical examination and examination information, inquiring a support database, judging whether the drugs in an anticoagulant drug reforming list are forbidden, whether drug treatment risks need to be reduced or not and whether drug treatment risks need to be increased or not, if so, prompting that the drug use risks exist, and giving a suggested value according to the support database; if the three problems do not exist, the conclusion that the current treatment scheme has no problem is given.
The following illustrates the operation process of the medication warning sub-module, and the set of the drugs in the anticoagulant reforming list is set as M ═ M1(m1)、M2(m2)、…、Mn(mn) In which M is1-MnName of anticoagulant drug, m1-mnIs the corresponding dose; first, the patient information given in the two sub-modules is obtained, for example: blood pressure value, liver function level, kidney function level and other information of the patient; secondly, inquiring a support database, judging whether the drugs in the anticoagulant drug reforming list are forbidden, reduced and added according to suggested values given by the support database, if so, prompting, and if not, giving a conclusion of no problem.
As shown in the following table, after the support database is queried according to the patient information acquired by the clinical examination information acquisition sub-module, the obtained warning information is: medicine M1The dosage is insufficient, and the recommended dosage is N1(ii) a Medicine M5Overdose, recommended dose N5. According to the liver and kidney function information of the patient obtained by the liver and kidney function submodule, after the support database is inquired, the obtained warning information is as follows: medicine M3Should be disabled. The alarm information finally given is as follows: medicine M1The dosage is insufficient, and the recommended dosage is N1(ii) a Medicine M3Should be disabled; medicine M5Overdose, recommended dose N5。
Preferably, in order to facilitate the distinction, different colors are used for prompting, red is forbidden for the current anticoagulant drugs, yellow is used for prompting that the drug treatment risk needs to be reduced, brown is used for prompting that the drug treatment risk needs to be increased, and blue is a current treatment scheme and has no problem temporarily.
Compared with the prior art, the scheme has the advantages that: set up on the evaluation module of using medicine and use medicine and warn, judge through the medicine information to the patient, form the warning of using medicine, distinguish anticoagulant drug treatment scheme forbidden item through different signs, there is the drug treatment risk and need reduce the volume item, there is drug treatment risk and need add the volume item and present treatment scheme problem-free item, thereby make medical personnel and patient can clearly whether current anticoagulant drug uses rationally and whether need add volume or decrement, the risk of patient in anticoagulant drug treatment has been reduced, the rationality of prescription has been increased.
Preferably, the drug interaction submodule comprises the following modules: a drug interaction database; and an interaction judging grandchild module.
Drug interaction database: used for storing the interaction information of the anticoagulant medicament and other medicaments. For example: the combination of anticoagulant drugs with non-steroidal anti-inflammatory drugs may increase the risk of bleeding in patients; the combination of an anticoagulant drug with a CYP3a 4-induced drug will affect the efficacy of the anticoagulant drug.
Preferably, the drug interaction database specifies the magnitude of the drug interaction.
Preferably: the magnitude of drug interactions is divided into four categories of risk according to the outcome of the interaction: contraindication and forbidding combination, otherwise, the effectiveness and the safety are seriously influenced; severe, if necessary, careful combination, moderate effects on effectiveness and safety; moderate, can be combined, slightly affects effectiveness and safety; slight, can be combined together, and does not influence the effectiveness and the safety.
The interaction judging module is used for: and judging whether the medicines in the anticoagulation medicine reforming list have interaction with the medicines in the other medicine reforming list which is taken by the patient due to other diseases or not and the magnitude of the interaction according to the medicine interaction database. I.e. to determine which of the four classes of risk the interaction belongs to.
Compared with the prior art, the scheme has the advantages that: the module judges the interaction between the anticoagulant and other medicines used by the patient, so that the medicines which have the interaction with the anticoagulant and the medicines which do not have the interaction with the anticoagulant are distinguished, and further, whether the medicines in the initial anticoagulant reforming list have the interaction with the medicines which are taken by the patient due to other diseases or not and the size of the interaction are determined. When facing a patient using a plurality of medicines, a pharmacist can fully consider the interaction relation between the medicines for anticoagulation treatment and the medication method which is taken by the patient due to other diseases in the process of determining the final medication scheme, so that scientific guidance is provided for the final decision of the pharmacist, and the occurrence of adverse events of the medicines is greatly reduced.
Preferably, the comprehensive assessment dosing regimen sub-module comprises: an adjustment submodule and a pharmacist confirmation submodule.
Preferably, the adjustment submodule is configured to: and adjusting the anticoagulant reforming list submodule according to the medication warning submodule. Specifically, the current anticoagulant reforming list submodule is adjusted according to the warning information and the suggested value given by the medication warning submodule to form an adjusted medication scheme.
Preferably, the pharmacist validation submodule is operable to: forming the final medication.
Preferably, in the pharmacist confirmation submodule, the medication scheme before adjustment, the medication scheme after adjustment, the warning information formed by the medication warning submodule, and the judgment result of the interaction judgment grandchild module are transmitted to the pharmacist side, and the pharmacist determines the final comprehensive medication scheme after adjustment and determination are performed according to the information.
Preferably, the general medication regimen includes the names of the drugs, the dosage of the drugs, the frequency of use of the drugs, the care of life and food contraindications for the use of the medication regimen.
Compared with the prior art, the scheme has the advantages that: by adopting the medication scheme determination scheme provided by the comprehensive evaluation medication scheme submodule, on one hand, the medication scheme is more suitable for the state of illness and physical condition of the patient, and on the other hand, whether the medication scheme conflicts with other medicines taken by the patient is fully considered, so that the finally obtained medication scheme is more optimal. In addition, the administration scheme comprehensive evaluation submodule can provide sufficient reference information for a pharmacist, so that the time required by the pharmacist for determining the administration scheme is greatly reduced, and the efficiency is improved.
Preferably, the question and evaluation module comprises a medication analysis sub-module, a feedback sub-module and a summary sub-module.
Preferably, the medication analysis submodule is used for comparing and analyzing the anticoagulant drug reforming list and the comprehensive medication scheme and forming a specific analysis report.
Preferably, the specific analysis report includes: the list of anticoagulation drug reformulations lists the change in the dosage of each drug compared to the final dosage regimen.
Preferably, the specific analysis report further comprises: the dosage of various medicines varies.
Preferably, the specific analysis report is formed by using a comparative analysis table. Illustratively, the following table is used:
the above table is only illustrative and is not meant to limit the present invention.
Preferably, the feedback sub-module sends the specific analysis report to the physician through the physician side.
Preferably, the summarization sub-module uploads the specific analysis report to an analysis report summarization database for summarization.
Compared with the prior art, the scheme has the advantages that: by feeding back a specific analysis report to the physician, the physician can be made aware of the final medication scheme, which facilitates the physician to improve the level. Secondly, specific analysis reports of each time are collected through the collection submodule, so that defects in the medication process can be conveniently and regularly cleared up, and a systemic medication suggestion is formed.
Preferably, the medication plan module comprises: a personal medication plan sub-module; a food contraindication event submodule; a life notice sub-module; and a medicine monitoring plan sub-module.
Preferably, the personal medication plan sub-module is configured to communicate the integrated medication regimen determined in the medication evaluation module to the patient.
Preferably, the medication regimen determined in the comprehensive assessment dosing regimen sub-module is communicated to the patient on the patient side.
Preferably, the food contraindication sub-module is adapted to inform the patient of food precautions during administration.
Preferably, the patient is informed of food contraindications determined in the comprehensive assessment dosing regimen sub-module via the patient side.
Preferably, the event of life sub-module is used to notify the patient of events that should be taken care of during the medication period.
Preferably, the patient is informed of the life precautions determined in the integrated assessment dosing regimen sub-module via the patient side.
Preferably, the medication monitoring planning sub-module comprises a checking inspection item informing grandchild module and a treatment scheme adjusting grandchild module.
Preferably, the inspection item informing module informs the patient of the name and frequency of the inspection item to be inspected through the patient side and informs the monitoring item of the normal range.
Preferably, in the treatment plan adjusting module, after finding that the examination result of the item to be monitored exceeds the normal threshold, the patient side uploads the abnormal index, and the physician/pharmacist obtains the abnormal index through the physician side/pharmacist side, adjusts the medication plan, and updates the adjusted medication plan in the personal medication plan sub-module.
For example: in the anticoagulant therapy using warfarin, the dosage of the drug needs to be adjusted according to the index of INR. Specifically, for the threshold, INR needs to be controlled at 2-3. If the INR value is less than 2, the warfarin dosage will need to be increased, and if the INR value is greater than 3, the warfarin dosage will need to be decreased. In terms of frequency, the INR monitoring frequency is: the INR is required to be rechecked every 3 days during the period of beginning to take warfarin until the INR is maintained to reach the standard, the detection times can be gradually reduced, the detection interval is prolonged to 3 days, 1 week, 2 weeks and 4 weeks, and the INR is rechecked at least every 4 weeks. The pharmacist informs the grandchild module of the monitoring threshold of the review INR and the frequency of the review INR through the examination and verification items in the medication care planning sub-module. The patient performs the review according to the requirement, when the INR value is higher than 3 or the INR value is lower than 2, the patient uploads the abnormal index through the patient end, and after the doctor/pharmacist obtains the abnormal index through the doctor end/pharmacist end, the medication scheme is adjusted, and the adjusted medication scheme is updated in the personal medication plan sub-module.
Compared with the prior art, the scheme has the advantages that: the drug monitoring plan submodule provided by the invention is beneficial to evaluating the medication condition and the medication effect of a patient, is convenient for medical staff to adjust the dosage of the anticoagulant drug according to the condition of the patient, and further reduces the risk of the patient caused by insufficient or excessive dosage of the anticoagulant drug.
Preferably, the physician side is used for the physician to upload information to the system and receive relevant information from the system.
Preferably, the pharmacist side is used for the pharmacist to upload information to the system and receive relevant information from the system.
Preferably, the patient side is used for the patient to upload information to the system and to receive relevant information from the system.
In the description of the present invention, it should be noted that the terms "upper", "lower", and the like refer to orientations or positional relationships based on those shown in the drawings, or orientations or positional relationships that are conventionally arranged when the products of the present invention are used, or orientations or positional relationships that are conventionally understood by those skilled in the art, and such terms are used for convenience of description and simplification of the description, and do not refer to or imply that the devices or elements referred to must have a specific orientation, be constructed and operated in a specific orientation, and thus, should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and the like are used merely to distinguish one description from another, and are not to be construed as indicating or implying relative importance.
The above embodiments are only used for illustrating the invention and not for limiting the technical solutions described in the invention, and although the present invention has been described in detail in the present specification with reference to the above embodiments, the present invention is not limited to the above embodiments, and therefore, any modification or equivalent replacement of the present invention is made; all such modifications and variations are intended to be included herein within the scope of this disclosure and the appended claims.
Claims (10)
1. An anticoagulant drug treatment management follow-up system, which is characterized in that: the system comprises a patient basic information data acquisition module, a medication evaluation module, a question and evaluation module, a medication plan module, a doctor end, a pharmacist end and a patient end; the patient basic information data acquisition module comprises: a hospital data retrieval submodule; an out-of-hospital data entry sub-module; the hospital data retrieval submodule is used for obtaining patient information from a hospital database, and the patient information comprises basic information, health information and hospital treatment records; the out-of-hospital data entry sub-module is used for entering the condition that the patient is in a visit outside the hospital.
2. The anticoagulant medication therapy management follow-up system according to claim 1, wherein: the basic information at least comprises the age, the sex and the identification number of the patient; the health information at least comprises information of other diseases suffered by the patient at present and medication contraindication information; the information of other diseases at least comprises the names of other diseases suffered by the patient at present and treatment schemes adopted aiming at each other diseases; medication contraindication information includes patient contraindications for medications; the hospital treatment record at least comprises the time of the hospital visit, the clinic visit, the examination and examination result, the diagnosis result and the medication scheme information.
3. The anticoagulant medication therapy management follow-up system according to claim 1, wherein: the out-of-hospital data entry module comprises an image recognition entry module and a manual entry module; the image identification and input module is used for identifying and inputting image information such as medical advice, examination and inspection results, medication schemes and the like generated in the out-of-hospital visit; the patient takes a picture of medical advice, examination and inspection results and a medication scheme outside a patient hospital through the camera equipment at the patient end, and performs OCR recognition and entry on the obtained picture; the manual entry module is used for manually correcting data which cannot be identified or is identified with errors in image identification entry by a patient, and correcting whether units of data outside a hospital are consistent with those inside the hospital or not.
4. The anticoagulant medication therapy management follow-up system according to claim 1, wherein: the medication evaluation module comprises: a drug reforming list submodule; a clinical examination and examination information acquisition submodule; a liver and kidney function submodule; a medication warning submodule; a drug interaction submodule; a comprehensive assessment dosing regimen sub-module.
5. The anticoagulant medication therapy management follow-up system according to claim 4, wherein: the drug reforming list submodule is used for acquiring and integrating the current drug administration schemes of the patient inside and outside a hospital to form an initial drug reforming list; the list of initial drug reformulations includes: other drug reforming lists, anticoagulant drug reforming lists; the reforming method of other drug reforming lists is: for other disease medication regimens used by patients for a long period of time, the last dose is tabulated for other drug reformulations; the reforming method of the reforming list of the anticoagulant drugs comprises the following steps: medicines related to only the hospital medication scheme or the hospital external medication scheme are directly listed in a final reforming scheme, and medicines related to the hospital medication scheme and the hospital external medication scheme are listed in an anticoagulant reforming list according to the last administration dosage; the clinical examination information acquisition submodule is used for summarizing the clinical examination information of the patient, and specifically summarizes the following information: the inspection and inspection results in the hospital data calling sub-module and the inspection and inspection results recorded by the hospital data recording sub-module; the liver and kidney function submodule is used for: measuring the liver and kidney function level of the patient by clinical examination data and combining the collected data of the basic information of the patient; the medication warning submodule is used for warning the treatment scheme of the patient, and the warning comprises an anticoagulant medicament forbidden identifier, a medicament treatment risk decrement-requiring identifier, a medicament treatment risk increment-requiring identifier and a problem-free identifier of the current treatment scheme; the medication warning submodule comprises a support database and a warning judgment sun module; the support database includes suggested values for anticoagulant use for different patients; the warning judgment sun module is used for respectively acquiring patient information given by the sub-modules, namely the sub-module and the liver and kidney function sub-module according to the clinical examination information, inquiring the support database, judging whether the drugs in the anticoagulant drug reforming list are forbidden to be used, whether the drug treatment risks need to be reduced or not and whether the drug treatment risks need to be increased or not, if so, prompting the existence of the drug use risks and giving a suggested value according to the support database; if the three problems do not exist, the conclusion that the current treatment scheme has no problem is given; the medication warning submodule prompts through different colors, wherein red indicates that the existing anticoagulant drugs are forbidden, yellow indicates that the medication risk needs to be reduced, brown indicates that the medication risk needs to be increased, and blue indicates that the existing treatment scheme has no problem temporarily; the drug interaction submodule comprises the following modules: a drug interaction database and an interaction judging sun module; the drug interaction database is used for storing interaction information of the anticoagulant drug and other drugs; the size of the drug interaction is specified in the drug interaction database; the magnitude of drug interactions is divided into four categories of risk according to the outcome of the interaction: contraindication and forbidding combination, otherwise, the effectiveness and the safety are seriously influenced; severe, if necessary, careful combination, moderate effects on effectiveness and safety; moderate, can be combined, slightly affects effectiveness and safety; the composition is slight, can be combined, and does not influence the effectiveness and the safety; the interaction judging sun module is used for judging whether the medicines in the anticoagulation medicine reforming list have interaction with the medicines in other medicine reforming lists which are taken by the patient due to other diseases or not and judging the magnitude of the interaction according to the medicine interaction database.
6. The anticoagulant medication therapy management follow-up system according to claim 5, wherein: the comprehensive evaluation dosing regimen submodule includes: an adjusting submodule and a pharmacist confirming submodule; the adjustment submodule is used for adjusting the anticoagulant reforming list submodule according to the medication warning submodule; the pharmacist confirmation submodule is used for forming a final medication scheme; in the pharmacist confirmation submodule, transmitting the medication scheme before adjustment, the medication scheme after adjustment, warning information formed by the medication warning submodule and a judgment result of the interaction judgment grandchild module to a pharmacist end, and after the pharmacist adjusts and determines according to the information, determining a final comprehensive medication scheme; the comprehensive medication scheme comprises the names of the medicines, the dosage of the medicines, the use frequency of the medicines, and the living care and food contraindications of using the medication scheme.
7. The anticoagulant medication therapy management follow-up system according to claim 6, wherein: the problem and evaluation module comprises a medication analysis submodule, a feedback submodule and a gathering submodule.
8. The anticoagulant medication therapy management follow-up system according to claim 7, wherein: the medication plan module includes: a personal medication plan sub-module; a food contraindication event submodule; a life notice sub-module; and a medicine monitoring plan sub-module.
9. The anticoagulant medication therapy management follow-up system according to claim 8, wherein: the personal medication plan sub-module is used for informing the patient of the comprehensive medication scheme determined in the medication evaluation module; the food contraindication sub-module is used for informing the patient of the food attention during the medication period; the life attention sub-module is used for informing the patient about the matters which should be taken care of in life during medication.
10. The anticoagulant medication therapy management follow-up system according to claim 9, wherein: the medicine monitoring plan sub-module comprises a checking and checking item informing grandchild module and a treatment scheme adjusting grandchild module; the inspection item informing module informs the name and frequency of the inspection item to be inspected to the patient through the patient end and informs the normal range of the monitoring item; the treatment scheme adjusting sun module is used for uploading the abnormal indexes through the patient end after the patient finds that the checking results of the items to be monitored exceed the normal threshold, and adjusting the medication scheme after a doctor/pharmacist obtains the abnormal indexes through the doctor end/pharmacist end and updating the adjusted medication scheme in the personal medication plan sub-module.
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN114452133A (en) * | 2022-03-10 | 2022-05-10 | 四川省医学科学院·四川省人民医院 | Nursing method and nursing system based on hierarchical monitoring mode |
| CN117457215A (en) * | 2023-12-20 | 2024-01-26 | 深圳市尼罗河移动互联科技有限公司 | Pediatric drug complications monitoring system |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN102737165A (en) * | 2012-06-07 | 2012-10-17 | 北京太元通软件科技有限公司 | Clinical medication decision support system |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN102737165A (en) * | 2012-06-07 | 2012-10-17 | 北京太元通软件科技有限公司 | Clinical medication decision support system |
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN114452133A (en) * | 2022-03-10 | 2022-05-10 | 四川省医学科学院·四川省人民医院 | Nursing method and nursing system based on hierarchical monitoring mode |
| CN114452133B (en) * | 2022-03-10 | 2023-06-20 | 四川省医学科学院·四川省人民医院 | Nursing method and nursing system based on hierarchical monitoring mode |
| CN117457215A (en) * | 2023-12-20 | 2024-01-26 | 深圳市尼罗河移动互联科技有限公司 | Pediatric drug complications monitoring system |
| CN117457215B (en) * | 2023-12-20 | 2024-03-08 | 深圳市尼罗河移动互联科技有限公司 | Pediatric drug complications monitoring system |
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