JP2007037823A - Medicine dose dispensing support system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an ultrasonic diagnostic apparatus which determines whether or not a medicine described on a prescription is contraindicated based upon prescription information and a preset contraindication level, and displays the determination result and the contraindication level so that we can easily check the contraindication level serving as the determination criterion on its monitor. <P>SOLUTION: This medicine dose dispensing support system comprises: an input section 11 for inputting prescription information on a subject; a data storage section 15 for storing contraindicative information on medicines, a contraindication level setting section 16 for setting a permissible contraindication level; a contraindication determining section 17 for determining whether or not a medicine described on the subject's prescription is contraindicated based upon the permissible contraindication level set by the contraindication level setting section; and a display section 19 for displaying the contraindication result about the prescribed medicine determined by the contraindication determining section as well as displaying the contraindication level set by the contraindication level setting section. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a dispensing support system for assisting a pharmacist to dispense a medicine based on a prescription issued by a doctor who diagnosed a subject.

  In the medical field, doctors diagnose and treat subjects, issue prescriptions, and pharmacists dispense medicines based on prescriptions. Various dispensing support systems for supporting effective dispensing have been proposed.

In the conventional dispensing support system, medicine specifying information for specifying a plurality of injections, standard amount information, application interval information for each of a plurality of anticancer drug injections, and a prescription amount calculation master coefficient are stored in a storage medium in advance. An injectable drug database 51, an incompatible drug database 52 in which information on incompatible drugs and compounded contraindications for a plurality of injected drugs is stored in a storage medium in advance, and subject identification information on a plurality of subjects Prescription information for injections is stored in a storage medium, and for a cancer subject, a patient database 53 in which information on a disease name, height, and weight is stored, and for each anticancer agent, An anticancer agent prescription history database 54 for each subject that stores prescription history information of anticancer agents including lifetime dosage information on the limits of lifetime medication is provided in a storage medium. A combination contraindication determination unit 55 that determines whether or not a combination contraindication occurs for a plurality of types of injection solutions applied to each subject using information in the database 52 and the subject database 53; A pH fluctuation determination unit 56 that determines whether or not a pH fluctuation occurs when a plurality of types of injections are mixed in a common infusion using information in the database 51 and the subject database 53; , Subject database 53 and subject-specific anticancer agent prescription history database 54, for each cancer subject, the prescription amount of the anticancer agent for each application and its application interval And anticancer agent appropriateness determination unit 57 for determining whether or not the cumulative dose does not exceed the lifetime dose for each anticancer agent, a prescription error, a medication error, Can prevent overdosing of anticancer drugs Those (e.g., see Patent Document 1).
JP 2004-121526 A

  However, the conventional dispensing system is incompatible with the injectable drug database containing the drug identification information, the standard amount information, the application interval information for each anticancer drug injection, and the master coefficient for calculating the prescription amount. Incompatibility database that stores information on injectable drugs and combination contraindications in storage media in advance, and subject database that stores patient identification information and information on disease name, height, and weight for cancer subjects To determine whether or not a combination contraindication occurs for multiple types of injections for each application applied to each subject. Only the status determination result is displayed, and it is not possible to easily know how the current contraindication criteria that are the basis of the determination are set.

  The present invention was made in order to solve such a conventional problem. When a pharmacist dispenses a medicine based on prescription information of a prescription issued by a doctor, both the medicinal effect and side effects of the medication are considered. A pharmacist sets a contraindication level, and determines the combination contraindication, combined use contraindication, and subject contraindication based on the set contraindication level, and displays the contraindication level that is a criterion for the contraindication state along with the determination result. The purpose is to provide a possible dispensing support system.

  The dispensing support system of the present invention includes an input unit that inputs prescription information for a subject, a drug data storage unit that stores contraindication information about a drug, a contraindication level setting unit that sets a contraindication level that enables medication, A contraindication determination unit that extracts contraindication information about a drug described in the prescription information from the drug data storage unit, and performs a contraindication determination of the drug described in the prescription information based on the contraindication level set in the contraindication level setting unit; And a display unit for displaying a contraindication level set by the incontinence level setting unit together with a contraindication determination result of the prescription drug determined by the contraindication determination unit.

  With this configuration, the drug listed in the prescription is contraindicated based on the prescription information in the prescription and the preset contraindication level, the determination result is displayed, and the contraindication level that has become the criterion for incontinence status is displayed. Can be displayed together. Thereby, it is possible to easily confirm the contraindication level used as the determination criterion on the screen displaying the result of the contraindication determination.

  Further, the dispensing support system of the present invention has a configuration in which at least one of the contraindication levels set by the incontinence level setting unit includes a combination incontinence level, a combined contraindication level, and a subject contraindication level.

  With this configuration, the contraindication levels of combination contraindication, combined contraindication, and subject incontinence can be set.

  A medication schedule creation unit for creating a medication schedule based on the prescription information of the prescription is further provided, and the display unit further displays the medication schedule.

  With this configuration, a medication schedule for creating a medication schedule based on the contraindication determination result can be created and displayed.

  The dispensing support system of the present invention has a configuration in which the contraindication level set by the contraindication level setting unit is accumulated in the subject database of the subject.

  With this configuration, the contraindication level set for each subject can be accumulated in the subject database, and fine medication conditions according to the subject can be determined.

  The dispensing support system of the present invention includes an input unit that inputs prescription information for a subject, a drug data storage unit that stores contraindication information about a drug, a contraindication level setting unit that sets a contraindication level that enables medication, A contraindication determination unit that extracts contraindication information about a drug described in the prescription information from the drug data storage unit, and performs a contraindication determination of the drug described in the prescription information based on the contraindication level set in the contraindication level setting unit; And a display unit for displaying a contraindication level set by the incontinence level setting unit together with a contraindication determination result of the prescription drug determined by the contraindication determination unit.

  This makes it possible to easily check the contraindication level used as a criterion for determination on the screen displaying the result of the contraindication determination, thereby improving the efficiency of the dispensing operation performed by the pharmacist.

  Hereinafter, a dispensing support system according to an embodiment of the present invention will be described with reference to the drawings.

(Embodiment 1)
FIG. 1 is a block diagram showing a configuration of a dispensing support system according to Embodiment 1 of the present invention.

  In FIG. 1, the dispensing support system according to the present embodiment has an input unit 11 for inputting prescription information, personal information of a subject, diagnostic information, and the like from a keyboard or the like based on a prescription issued by a doctor who diagnosed the subject. And personal information such as subject ID, name, gender, date of birth, blood type, insurance card number, height, weight, etc. of multiple subjects, presence or absence of pregnancy, constitution, medical history, medicine Subject database 12 that accumulates diagnostic information such as history, side effect history, and drug information such as efficacy, effects, usage, dosage, precautions for multiple drugs, combined use contraindications and combination contraindications for multiple drugs Drug database 13 that stores contraindication information such as contraindications, measures, mechanisms of action, etc., the degree of risk to the body due to contraindications related to multiple medicines, and medicine by medication A data storage unit 15 that stores a contraindication level database 14 that stores contraindication level information that represents a relationship between incontinence levels that takes into account both effects and side effects, and a contraindication level for each of the combination contraindications, combined contraindications, and subject contraindications. Concomitant or contraindicated for pharmaceuticals described in a prescription issued by a doctor based on information on a contraindication level setting unit 16 set by a pharmacist for each subject and a contraindication level set by the contraindication level setting unit 16 The drug name of the drug dispensed with the prescription input from the input unit 11 with reference to the contraindication determination unit 17 for determining the subject's contraindication and the contraindication determination result of the contraindication determination unit 17, A dosing schedule creation unit 18 for creating a dosing schedule such as dosing timing, dosing amount of the medicine and precautions for taking the medicine, and a subject database for each subject. A structure having a display unit 19 such as a display for displaying the dosing schedule created by some contraindicated level setting unit 16 contraindicated level pharmacist set in the dosing schedule creation unit 18 of the 12 personal information.

  Note that the prescription information and the personal information and diagnostic information of the subject input from the input unit 11 may be information received using a network established in a hospital such as an ordering system or an electronic medical record system. In addition, information transmitted from a hospital or the like to which a doctor who diagnosed the subject belongs may be information received via a communication network such as the Internet using a confidential means such as encryption. Furthermore, information input from a keyboard or the like at a pharmacy to which the pharmacist belongs may be used.

  Further, the drug database 13 and the contraindication level database 14 may be integrated databases instead of separate databases.

  About the dispensing assistance system of this invention comprised as mentioned above, the operation | movement is demonstrated using the flowchart of FIG.

  In this embodiment, it does not matter whether the subject is a first visit or revisit.

  In FIG. 2, first, the pharmacy that has received the prescription issued by the doctor who diagnosed the subject inputs a part of the subject's personal information such as the subject ID, name, sex, and age from the input unit 11. Then, the subject is identified by collating with the subject database 12 of the data storage unit 15 (S21), and the prescription information described in the prescription in the subject subject database 12 of the identified subject is input from the input unit 11. Input (S22).

  Furthermore, there is no addition or change in the contents of the personal information and diagnostic information of the subject accumulated in the subject database 12 of the identified subject, and in particular, drugs currently being taken to avoid duplicate medication Check whether there is no pregnancy, whether there is a pregnancy, whether there is an infant, etc. by a method such as an interview, and if there are additions or changes, the subject of the subject specified by inputting the latest data from the input unit 11 The database 12 is updated (S23).

  Next, in the contraindication level setting unit 16, the pharmacist sets the combination incontinence level, the combined contraindication level, and the subject contraindication level in consideration of both the medicinal effect and side effects of the medication (S24).

  The contraindication levels of combination contraindication, combined contraindication, and subject incontinence are stored in advance in the contraindication level database 14. For example, FIG. 3 shows an example of the contraindication level between drugs.

  FIG. 3 shows a method for determining combined contraindications.

  In FIG. 3, when each of the target drug and the partner drug is administered in combination, the effect of the drug may decrease due to the interaction between the drugs, or may cause a harmful effect. The combined contraindication level, which is the magnitude of the degree of risk to the subject's body, is represented by a graph, and numbers 1, 2, 3, 4, and 5 are shown in ascending order of interaction.

  Information on the interaction can be referred to the Ministry of Health, Labor and Welfare Drug Master, or based on the contents of warnings, contraindications, in principle contraindications, etc. described in the documents attached to each drug.

  In FIG. 3, for example, when the concomitant contraindication criteria is set to level “2”, when the drug described in the prescription issued by the doctor contains aminophylline and bromhexine hydrochloride, the concomitant contraindication level is “4”. Since the set combined contraindication criteria exceeds the level “2”, it is determined that medication is not possible.

  The method for setting the contraindication level may be a method of selecting a contraindication level displayed at a designated position of a display device such as a display, or a method of inputting from a keyboard or the like.

  With regard to the combination contraindication, the combination contraindication level is set as described above, and is stored in the contraindication level database 14. In addition, regarding the contraindication of the subject, the degree of the influence of the pharmaceutical on the allergic constitution and the influence on the fetus and the infant is set as the subject incontinence level and accumulated in the contraindication level database 14.

  Next, the diagnosis information of the subject stored in the subject database 12 of the identified subject is compared with the drug described in the prescription and the subject contraindication level set by the contraindication level setting unit 16. Then, the subject contraindication is determined (S25).

  If there is no problem in determining whether the subject is contraindicated (YES in S25), a message to that effect is displayed on the display unit 19, and the medicine described in the prescription is first subject to medication. If there is a problem in the determination of subject contraindication (NO in S25), the fact is displayed on the display unit 19, the medicine described in the prescription is excluded from the medication, and the doctor who issued the prescription is checked for doubt. Perform (S26).

  If there is no problem as a result of the question collation with the doctor (YES in S26), it is set as a medication target. If there is a problem as a result of the question collation with the doctor (NO in S26), the doctor issues a revised prescription and inputs the prescription information described in the revised prescription from the input unit 11 (S22).

  Next, the contraindication information stored in the drug database 13 and the drug described in the prescription and the combination contraindication level set by the contraindication level setting unit 16 are collated to determine the combination contraindication (S27).

  When there is no problem in the determination of the contraindication (YES in S27), that effect is displayed on the display unit 19, and the medicine described in the prescription is further subject to medication. If there is a problem in the determination of the contraindication (NO in S27), the fact is displayed on the display unit 19, the medicine described in the prescription is excluded from the medication, and the doctor who issued the prescription is checked against the question ( S28).

  If there is no problem as a result of the question verification to the doctor (YES in S28), it is determined as a medication target. When there is a problem as a result of the question collation with the doctor (NO in S28), the prescription is revised and issued by the doctor, and the prescription information described in the revised prescription is input from the input unit 11 (S22).

  Next, the contraindication information stored in the drug database 13 is compared with the drug described in the prescription and the combination contraindication level set by the contraindication level setting unit 16 to determine the combination contraindication (S29).

  If there is no problem in the combined contraindication determination (YES in S29), the fact is displayed on the display unit 19, and the medicine described in the prescription is further subject to medication. If there is a problem in the combined contraindication determination (NO in S29), that fact is displayed on the display unit 19, the medicine described in the prescription is excluded from the medication, and the question is collated with the doctor who issued the prescription ( S30).

  If there is no problem as a result of the question collation with the doctor (YES in S30), the subject is to be administered. If there is a problem as a result of the question collation with the doctor (NO in S30), the prescription is revised and issued by the doctor, and the prescription information described in the revised prescription is input from the input unit 11 (S22).

  The drug to be administered to the subject is determined by the steps so far. When there is a need for dispensing among a plurality of medicines, the pharmacist determines a medicine to be specifically dispensed (S31).

  Next, a medication schedule is created based on a protocol selected from a plurality of regimens that are standardized treatment plans and created according to the constitution and symptoms of the subject (S32). The daily dosage, medication time (before meal, after meal, between meals, before going to bed, etc.), number of days of medication, precautions for medication, etc. are clarified by the medication schedule preparation.

  Next, a prescription audit is performed (S33). If there is no problem in the prescription audit (YES in S33), that effect is displayed on the display unit 19, and the content of the above-mentioned medication schedule is added as the medical history to the diagnostic information of the subject database 12 of the identified subject. Are accumulated (S34), and the process is terminated. When there is a problem in the prescription inspection (NO in S33), that effect is displayed on the display unit 19, and the process returns to step (S31).

  FIG. 4 is a diagram illustrating an example of a display screen displayed on the display unit 19.

  In FIG. 4, a subject information frame 41 is diagnosed as a part of personal information (subject ID, name, gender, date of birth, insurance card number, etc.) in the subject database 12 of the identified subject. Some of the information is displayed (eg allergies, pregnancy status, recent medical history, etc.).

  The contraindication level information frame 42 displays the determination results of the combination contraindication, combined contraindication, and subject incontinence set by the pharmacist for the subject displayed in the subject information frame 41.

  The medication schedule frame 43 displays the medication schedule for the subject displayed in the subject information frame 41.

  In the precautions frame 44, precautions regarding taking or storing the medicine displayed in the medication schedule frame 43 are displayed.

  The contraindication determination level display section 45 displays “2” indicating the determination level because the combined contraindication determination level is set to 2 in the present embodiment.

  In the above description, the determination reference levels are classified by numbers, but may be classified by colors such as green, blue, yellow, and red that are appealing visually.

  Further, the frame division and the frame arrangement of the display screen are not limited to this.

  As described above, according to the dispensing support system of the present embodiment, based on the contraindication level set by the pharmacist in consideration of both the medicinal effect and side effects of the medication, the medicine described in the prescription issued by the doctor A combination contraindication, a combined contraindication, and a subject contraindication are determined, and a determination result is displayed based on a result of the contraindication determination, and a contraindication level that is a determination criterion of the contraindication state is also displayed. This makes it possible to easily check the contraindication level used as a criterion for determination on the screen displaying the result of the contraindication determination, thereby improving the efficiency of the dispensing operation performed by the pharmacist.

  In addition, the contraindication level set for each subject is accumulated in the subject database, so if information is shared and multiple pharmacists are involved in dispensing work, the same contraindication level should be set for the same subject. It can be set easily.

  In this embodiment, the case where the pharmacist sets the subject contraindication level, the combination contraindication level, and the combined contraindication level has been described. However, if the pharmacist does not set the default value, a default value is determined in advance. It is also possible to configure so that the setting value is displayed and the set value is displayed on the display unit.

  In the present embodiment, the contraindication determination is described in the order of subject incontinence, combination incontinence, and combined use contraindication, but the order is not particular.

  As described above, the dispensing support system of the present invention includes an input unit that inputs prescription information for a subject, a pharmaceutical data storage unit that stores contraindication information about pharmaceuticals, and a contraindication that sets a contraindication level that enables medication. Extract the contraindication information about the drug listed in the prescription information from the level setting unit and the drug data storage unit, and determine the contraindication of the drug described in the prescription information based on the contraindication level set in the contraindication level setting unit A contraindication determination unit to perform, and a display unit for displaying a contraindication level set in the incontinence level setting unit together with a contraindication determination result of the prescription drug determined in the contraindication determination unit. This makes it easy to check the contraindication level that is the criterion for determination on the screen that displays the results of the contraindication determination, which is useful as a dispensing support system that assists pharmacists in dispensing pharmaceuticals based on prescriptions. It is.

The block diagram which shows the dispensing assistance system in Embodiment 1 of this invention. The flowchart which shows operation | movement of the dispensing assistance system in Embodiment 1 of this invention. The figure which shows an example of the combined use contraindication level of the dispensing assistance system in Embodiment 1 of this invention The figure which shows an example of the display screen of the dispensing assistance system in Embodiment 1 of this invention Block diagram showing a conventional dispensing support system

Explanation of symbols

DESCRIPTION OF SYMBOLS 11 Input part 12 Subject database 13 Pharmaceutical database 14 Contraindication level database 15 Data storage part 16 Contraindication level setting part 17 Contraindication judgment part 18 Medication schedule preparation part 19 Display part 41 Subject information frame 42 Contraindication level information frame 43 Medication schedule Frame 44 Notes frame 45 Contraindication level display

Claims (4)

An input unit for inputting prescription information for the subject;
A drug data storage unit that stores contraindication information about the drug,
A contraindication level setting unit for setting a contraindication level that enables medication;
Contraindication information about the drug described in the prescription information is extracted from the drug data storage unit, and the contraindication of the drug described in the prescription information is determined based on the contraindication level set in the contraindication level setting unit A contraindication determination unit;
A dispensing support system, comprising: a display unit for displaying a contraindication level set by the contraindication level setting unit together with a contraindication determination result of the prescription drug determined by the contraindication determination unit. The dispensing support system according to claim 1, wherein the contraindication level set by the contraindication level setting unit includes one of a combination contraindication level, a combined contraindication level, and a subject contraindication level. The dispensing support system according to claim 1, further comprising a medication schedule creation unit that creates a medication schedule based on prescription information of the prescription, wherein the display unit further displays the medication schedule. The dispensing support system according to any one of claims 1 to 3, wherein the contraindication level set by the contraindication level setting unit is accumulated in a subject database of the subject.

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