JP2021056971A - Contraindication determination system, contraindication determination program, and contraindication disease name database - Google Patents

Abstract

To provide a contraindication determination system, a contraindication determination program, and a contraindication disease name database capable of enhancing the determination accuracy of contraindication disease name of a chemical.SOLUTION: A contraindication determination system includes a first processing part capable of executing first determination processing for determining whether patient disease name information showing a disease name of a patient includes disease name information for determination showing a disease name for determination preset corresponding to a chemical prescribed to the patient, a second processing part capable of executing preset specification processing on the basis of a determination result by the first processing part, and can change the existence/non-existence of the execution of the first determination processing or contents of the specification processing in each combination about combinations having the same disease name information for determination and different chemicals among combinations of the chemicals and the disease name information for determination.SELECTED DRAWING: Figure 1

Description

The present invention relates to a contraindication determination system capable of determining contraindications for a combination of a drug and a disease name, a contraindication determination program, and a contraindication disease name database used therein.

In a medical institution such as a hospital, prescription data is issued by inputting a medical examination record and prescription contents into an electronic medical record system or the like, and a drug is dispensed based on the prescription data. The drug dispensed based on the prescription data is then used for the patient. There is known a system capable of executing a prescription check that automatically determines the suitability of the prescription data before dispensing the drug based on the prescription data (see, for example, Patent Document 1).

In particular, the package insert of a drug may include the name of a patient who is not suitable for the drug as a contraindicated disease name. Therefore, in the prescription check, it is conceivable that a contraindicated disease name check for determining the suitability of prescribing a drug to a patient is performed based on the patient's disease name and the contraindicated disease name of the drug.

Japanese Unexamined Patent Publication No. 2013-125377

By the way, regarding the contraindicated disease name, different expressions may be used when the cause, site, degree, sex, age and other modifiers of the disease name are different even if the disease name is of the same type. For example, even if the type of contraindicated disease name is the same type of "renal disorder", the drug whose contraindicated disease name described in the package insert is "serious renal disorder" and the contraindicated disease name described in the package insert are simply There may be drugs that are "kidney disorders".

However, on the system used in medical institutions, a specific code such as a receipt computer code specified by the Ministry of Health, Labor and Welfare or a standard disease name code specified by a medical institution is used as identification information for identifying a disease name. There is. The disease name that can be identified by the identification information used on the system (hereinafter, referred to as "determination disease name") may be expressed differently from the contraindicated disease name. Specifically, the modifier of the judgment disease name may not be taken into consideration in the judgment disease name. For example, as described above, "serious renal disorder" and "renal disorder" having different modifiers are the same. It may be expressed by the name of the disease for judgment.

Therefore, in the contraindicated disease name check, the modifier of the contraindicated disease name is not taken into consideration, and the determination accuracy of the contraindicated disease name may decrease. For example, if the patient's disease name is set to be contraindicated when the patient's disease name matches the judgment disease name "renal disorder" in the contraindicated disease name check, and the patient's disease name is "renal disorder", it is contraindicated. A drug whose disease name is "serious renal disorder" and a drug whose contraindicated disease name is "renal disorder" may be determined to be contraindicated. In this case, a drug that should be determined to be contraindicated only when the modifier is originally "serious" is also determined to be contraindicated, which causes unnecessary confirmation work by the user.

An object of the present invention is to provide a contraindication determination system, a contraindication determination program, and a contraindication disease name database capable of improving the determination accuracy of contraindicated disease names of drugs.

In the contraindication determination system according to the present invention, whether or not the patient disease name information indicating the patient's disease name includes the determination disease name information indicating the determination disease name preset according to the drug prescribed to the patient. The chemicals include a first processing unit capable of executing the first determination process for determining the above-mentioned drug, and a second processing unit capable of executing a preset specific process based on the determination result by the first processing unit. With respect to the combination of the determination disease name information having the same determination disease name information but different chemicals, it is possible to change whether or not the first determination process is executed or the content of the specific process for each combination.

The contraindication determination system according to the present invention belongs to one group of the patient disease name information indicating the patient's disease name and the determination disease name information indicating the determination disease name preset according to the drug prescribed to the patient. The first processing unit capable of executing the second determination process for determining whether or not a part of the determination disease name information selected in advance from the plurality of determination disease name information is included, and the first processing unit. A second processing unit that can execute preset specific processing based on the judgment result, and
The presence or absence of execution of the second determination process or the content of the specific process can be changed for each combination of the drug and a part of the determination disease name information.

The contraindication determination system according to the present invention belongs to one group of the patient disease name information indicating the patient's disease name and the determination disease name information indicating the determination disease name preset according to the drug prescribed to the patient. A first processing unit capable of executing a third determination process for determining whether or not all of the plurality of determination disease name information is included, and a predetermined specific process based on the determination result by the first processing unit. It is possible to change whether or not the third determination process is executed or the content of the specific process for each combination of the drug and the group.

In the contraindication determination program according to the present invention, the processor includes the patient disease name information indicating the patient's disease name and the determination disease name information indicating the determination disease name preset according to the drug prescribed to the patient. Contraindications for executing the first step of executing the first determination process for determining whether or not the patient is present, and the second step of executing a preset specific process based on the determination result of the first step. In the determination program, among the combinations of the drug and the determination disease name information, for the combination having the same determination disease name information but different drugs, the presence / absence of execution of the first determination process or the specific process for each combination. The contents of can be changed.

The contraindication determination program according to the present invention is one of the determination disease name information indicating the patient disease name information indicating the patient's disease name and the determination disease name preset in accordance with the drug prescribed to the patient in the processor. According to the first step of executing the second determination process of determining whether or not a part of the determination disease name information selected in advance from the plurality of determination disease name information belonging to the group is included, and the first step. It is a contraindication determination program for executing a second step capable of executing a preset specific process based on the determination result, and the first step is for each combination of the drug and a part of the determination disease name information. 2 Whether or not the determination process is executed or the content of the specific process can be changed.

The contraindication determination program according to the present invention is one of the determination disease name information indicating the patient disease name information indicating the patient's disease name and the determination disease name preset in accordance with the drug prescribed to the patient in the processor. A first step of executing a third determination process for determining whether or not all of the plurality of determination disease name information belonging to the group is included, and a specific process set in advance based on the determination result of the first step. It is a contraindication determination program for executing the second step, and it is possible to change whether or not the third determination process is executed or the content of the specific process for each combination of the drug and the group. ..

In the contraindicated disease name database according to the present invention, the processor includes, in the patient disease name information indicating the patient's disease name, the determination disease name information indicating the determination disease name preset in accordance with the drug prescribed for the patient. A contraindicated disease name database used when executing a determination process for determining whether or not a patient is present and executing a preset specific process based on the determination result of the determination process, which is the drug and the determination disease name information. Of the combinations, the presence or absence of execution of the determination process or the content of the specific process can be set for each combination of the combinations having the same determination disease name information but different drugs, and the processor can use the contraindicated disease name database. Based on the above, it is possible to change whether or not the determination process is executed or the content of the specific process for each combination of the drug and the determination disease name information.

According to the present invention, a contraindication determination system, a contraindication determination program, and a contraindication name database capable of improving the determination accuracy of contraindicated disease names of drugs are realized.

FIG. 1 is a block diagram showing a configuration of a contraindication determination system according to an embodiment of the present invention. FIG. 2 is a diagram showing an example of a data structure of a contraindicated disease name master used in the contraindication determination system according to the embodiment of the present invention. FIG. 3 is a flowchart showing an example of a procedure for setting a contraindicated disease name executed by the contraindication determination system according to the embodiment of the present invention. FIG. 4 is a diagram showing an example of a display screen displayed by the contraindication determination system according to the embodiment of the present invention. FIG. 5 is a diagram showing an example of a display screen displayed by the contraindication determination system according to the embodiment of the present invention. FIG. 6 is a diagram showing an example of a display screen displayed by the contraindication determination system according to the embodiment of the present invention. FIG. 7 is a flowchart showing an example of a procedure for contraindicated disease name determination processing executed by the contraindication determination system according to the embodiment of the present invention. FIG. 8 is a diagram showing an example of a display screen displayed by the contraindication determination system according to the embodiment of the present invention. FIG. 9 is a diagram showing an example of a display screen displayed by the contraindication determination system according to the embodiment of the present invention. FIG. 10 is a diagram showing an example of a display screen displayed by the contraindication determination system according to the embodiment of the present invention. FIG. 11 is a diagram showing an example of a display screen displayed by the contraindication determination system according to the embodiment of the present invention.

Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings for the purpose of understanding the present invention. It should be noted that the following embodiment is an example embodying the present invention and does not limit the technical scope of the present invention.

[Dispensing support system 10]
As shown in FIG. 1, the dispensing support system 10 according to the embodiment of the present invention includes a dispensing support device 1, a client terminal 2, a dispensing device 3, and a printer 4. The dispensing support system 10 is a system used to support a dispensing operation by a pharmacist, and is an example of a contraindication determination system according to the present invention. In the present embodiment, the user of the dispensing support system 10 is, for example, a pharmacist, a doctor, a nurse, or a medical staff.

In the dispensing support system 10, the dispensing support device 1, the client terminal 2, the dispensing device 3, and the printer 4 are connected wirelessly or by wire via a communication network 5. The communication network 5 is a LAN, WAN, Internet, intranet, or the like.

Further, a higher-level system 6 such as an electronic medical record system, an ordering system, or a receipt system for inputting prescription data, patient data, and the like into the dispensing support device 1 is connected to the dispensing support device 1 via the communication network 5. Will be done. The dispensing support device 1 may be configured to read the prescription data, the patient data, and the like from the higher-level system 6. Then, the dispensing support device 1 transmits the dispensing data for dispensing the drug in the dispensing device 3 based on the prescription data to the dispensing device 3.

The prescription data includes, for example, information such as patient name, patient ID, prescription ID, prescription issue date, drug identification information (drug code, drug name), dosage, usage, doctor in charge, clinical department, patient disease name information, ward, and the like. Is included. The patient data includes, for example, information such as patient name, patient ID, patient disease name information, gender, age, presence / absence of drinking, presence / absence of smoking, and allergies. In addition, the prescription data may include a part or all of the patient data. When the prescription data includes information such as the patient disease name information which is a part of the patient data, or when the patient disease name information is input by a user operation in the dispensing support system 10. The patient data does not have to be input from the higher-level system 6 to the dispensing support device 1.

The patient disease name information is an example of identification information for identifying a patient disease name such as a disease or trauma occurring in a patient, and is defined by the Ministry of Health, Labor and Welfare as the patient disease name information in the dispensing support system 10. The receipt computer code and the standard disease name indicated by the receipt computer code are used. The "disease name" in the present embodiment includes not only the name of the disease but also the name of the trauma. When there are a plurality of the patient disease names corresponding to one patient, the patient disease name information includes information on the plurality of patient disease names. Further, the patient disease name information may be either the receipt computer code or the standard disease name. The patient disease name information is registered in association with the patient in the higher-level system 6 or the dispensing support system 10. Further, in the dispensing support system 10, a standard disease name code defined by a medical institution may be used instead of the receipt computer code.

[Dispensing equipment 3]
Each of the dispensing devices 3 is used in a drug dispensing operation in a medical institution such as a hospital or a pharmacy where the dispensing support system 10 is used. For example, each of the dispensing devices 3 is a tablet packing machine, a powder packing machine, a liquid medicine dispensing machine, a PTP sheet dispensing device, a mixed dispensing device, or the like. For example, the tablet packaging machine has a plurality of drug cassettes containing a plurality of types of tablets, and according to the dispensing data input from the dispensing support device 1, the tablets are dispensed from the drug cassette for each dose. Perform the packaging operation of wrapping with packaging paper. The powder packaging machine executes a packaging operation of packaging the charged powder with a packaging paper for each dose according to the dispensing data input from the dispensing support device 1. The liquid medicine dispensing machine has a plurality of medicine bottles containing a plurality of types of liquid medicines, and a required amount of liquid medicine is prepared from the medicine bottle according to the dispensing data input from the dispensing support device 1. Pay out. The PTP sheet dispensing device has a plurality of sheet cassettes containing a PTP sheet in which tablets are pre-packaged or a heat seal, and the PTP from the sheet cassette according to dispensing data input from the dispensing support device 1. Pay out the sheet or the heat seal. The mixed injection device automatically executes a mixed injection operation of injecting a drug such as an anticancer drug into an infusion solution by a robot arm according to the dispensing data input from the dispensing support device 1.

[Printer 4]
The printer 4 is a color printer or a monochrome printer that prints information contained in print data input from the dispensing support device 1 or the client terminal 2 via the communication network 5 on a sheet such as paper.

[Dispensing support device 1]
The dispensing support device 1 is a personal computer including a control unit 11, a storage unit 12, a communication I / F 13, a display device 14, an operation device 15, a drive device 16, and the like. The dispensing support device 1 may be provided outside a medical institution such as a hospital where the dispensing support system 10 is used. Further, the dispensing support device 1 may be a mobile terminal such as a smartphone or a tablet terminal.

The communication I / F 13 communicates data wirelessly or by wire with the client terminal 2, the dispensing device 3, and an external device such as the printer 4 via the communication network 5 according to a predetermined communication protocol. It is a communication interface having a network card or the like for executing.

The display device 14 is a display unit such as a liquid crystal display or an organic EL display that displays various information according to a control instruction from the control unit 11. The operation device 15 is an operation unit operated by a user to input various information to the dispensing support device 1. Specifically, the operation device 15 includes a keyboard and a mouse (pointing device) that accept input operations on various operation screens displayed on the display device 14. Further, the operation device 15 may include a touch panel that accepts touch operations on various operation screens displayed on the display device 14, or a voice input device that accepts input of various information by voice recognition.

The drive device 16 can read the dispensing support program from a computer-readable recording medium 161 on which the dispensing support program including the contraindication determination program according to the present invention is recorded. The contraindication determination program is a control program for causing the control unit 11 to execute various processes such as a contraindication name setting process (FIG. 4) and a contraindication name determination process (see FIG. 7), which will be described later. The contraindicated disease name setting process is a process for setting the contraindicated disease name master D11 described later, and the contraindicated disease name determination process determines the suitability of prescribing a drug to a patient based on the contraindicated disease name master D11 described later. It is a process to do.

The recording medium 161 is a CD, DVD, BD, USB memory, or the like, and the drive device 16 is a CD drive, a DVD drive, a BD drive, a USB port, or the like. Then, in the dispensing support device 1, the dispensing support program read from the recording medium 161 by the control unit 11 using the drive device 16 is installed in the storage unit 12.

The control unit 11 includes control devices such as a CPU, ROM, RAM, and EEPROM. The CPU is a processor that executes various arithmetic processes. The ROM is a non-volatile storage unit in which information such as a control program for causing the CPU to execute various processes is stored in advance. The RAM is a volatile storage unit, and the EEPROM is a non-volatile storage unit. The RAM and EEPROM are used as a temporary storage memory (working area) for various processes executed by the CPU. Then, the control unit 11 uses the CPU to execute various processes according to various control programs stored in advance in the ROM, the EEPROM, or the storage unit 12.

The storage unit 12 is a non-volatile storage unit such as a hard disk or SSD that stores various control programs and various data executed by the control unit 11. Specifically, the storage unit 12 includes a program storage unit 121, an information storage unit 122, and a master storage unit 123.

The program storage unit 121 is a storage area in which the contraindication determination program is stored. The information storage unit 122 is a storage area for storing various types of information such as the prescription data and the patient data acquired from the higher-level system 6. The master storage unit 123 is a storage area for storing various master information such as a drug master, a disease name master, a patient master, and a contraindicated disease name master D11. For example, the drug master has a drug code (YJ code, etc.), a drug name, a JAN code, an RSS code, a drug bottle code, a dosage form, a unit, a specific gravity, a drug type, a compounding change, and an excipient for various drugs. , Notes and other information is included. The drug master also includes the contents of the package insert of the drug for each of the drugs. Further, in the disease name master, the receipt computer code and the standard disease name are registered as information for identifying the disease name indicating a disease or trauma.

The patient master is a database in which patient information corresponding to each patient is stored. The patient information includes, for example, a patient name, a patient ID, the patient disease name information, sex, age, presence / absence of drinking, presence / absence of smoking, allergies, and the like. The control unit 11 can appropriately update the patient master based on the prescription data or the patient data acquired from the higher-level system 6. Specifically, the control unit 11 registers the patient disease name information of the patient acquired from the higher-level system 6 or the patient disease name information included in the patient data in the patient master as the patient disease name information corresponding to the patient. .. Further, the control unit 11 can edit the patient disease name information of the patient master based on the user operation on the dispensing support device 1 or the client terminal 2.

The contraindicated disease name master D11 determines whether or not the prescription of the drug to the patient is appropriate based on the disease name (disease name) such as a disease or trauma expressed in the patient to whom the drug is prescribed. This is an example of a contraindicated disease name database used for the purpose. The control unit 11 can also edit the contraindicated disease name master D11 based on a user operation on the dispensing support device 1 or the client terminal 2. Here, FIG. 2 is a diagram showing an example of the contraindicated disease name master D11.

As shown in FIG. 2, in the contraindicated disease name master D11, the setting attribute indicating the attribute corresponding to the content that can be set as the determination method described later, the drug identification information for identifying the drug, and the drug. As information for determining contraindications, preset determination disease name information indicating a determination disease name is stored in association with the information. The determination disease name is used as information for determining contraindications for the combination of the drug and the disease name in the dispensing support system 10, and the name is different from the contraindicated disease name described in the package insert. Sometimes. In the present embodiment, the determination disease name information includes the receipt computer code and the standard disease name. That is, in the present embodiment, the standard disease name is used as the determination disease name. The determination disease name information may be any information that can identify the determination disease name, and may be either the receipt computer code or the standard disease name. For example, the determination disease name information is registered based on the contraindicated disease name described in the package insert of each of the drugs when the contraindicated disease name master D11 is created or updated. In FIG. 2, the case where the data is classified for each setting attribute in the contraindicated disease name master D11 is taken as an example, but in the data structure in which the data having different setting attributes are mixed in the contraindicated disease name master D11. There may be. Further, the item of the setting attribute may be omitted, and the contraindicated disease name master D11 corresponding to each setting attribute may be individually stored.

Further, in the contraindicated disease name master D11, as setting information for determining the determination method in the contraindicated disease name determination process, a check target flag and a check level are used for each combination of the drug identification information and the determination disease name information. , Check group is stored in association with each other. That is, in the contraindicated disease name master D11, the setting information corresponding to the combination of the drug and the determination disease name is registered for each drug indicated by the drug identification information.

The determination disease name information may include information in which information on a plurality of contraindicated disease names having the same type of disease name but different modifiers of the disease name is integrated. Specifically, the modifiers include information indicating the extent of the disease, such as "serious," "progressive," and causes, such as "allergic," "bacterial," and "hereditary." Information to indicate, information to indicate parts such as "ankle" and "face", information to indicate the age of the patient such as "juvenile", "adolescent" and "senile", "female", "male" Information indicating the gender of the patient, such as. For example, as shown in FIG. 2, "renal disorder" is described as a contraindicated disease name in the package insert of "drug M1", and "serious renal disorder" is described as a contraindicated disease name in the package insert of "drug M2". , But the judgment disease name corresponding to these contraindicated disease names may be integrated into "renal disorder". In FIG. 2, for the contraindicated disease name master D11, an example of the original text of the contraindicated disease name of the drug described in the package insert of the drug is described as a reference, but the information of the original text of the contraindicated disease name is described above. Contraindicated disease name It may or may not be included in the master D11. Further, here, the name of the disease for determination corresponding to "serious renal disorder" and "renal disorder" is set to the same name as "renal disorder" which is a disease name excluding the modifier "serious". This is an example, but it is not limited to this. For example, the determination disease name does not have to be the same as the name of the disease name portion excluding the modifier.

The check target flag is information indicating whether or not the first determination process or the second determination process in the contraindicated disease name determination process is executed for the combination of the drug and the determination disease name information. The first determination process is a process for determining whether or not the determination disease name information corresponding to the drug is included in the patient disease name information. That is, in the first determination process, it is determined whether or not the determination disease name indicated by the determination disease name information matches any of the patient disease names included in the patient disease name information. In the second determination process, a part of the determination disease name information selected in advance from a plurality of the determination disease name information belonging to one group of the determination disease name information corresponding to the drug is used as the patient disease name information. It is a process of determining whether or not it is included. That is, in the second determination process, the determination disease name indicated by a part of the determination disease name information selected in advance from the plurality of determination disease name information belonging to the same group is included in the patient disease name information. It is determined whether or not it matches any of the patient disease names. In the present embodiment, the group is described as a series of contraindicated disease names in the package insert of the drug, for example, the contraindicated disease name is "severe respiratory function decline in the acute phase of cerebrovascular accident". In that case, when the judgment disease name "cerebrovascular disorder" and "respiratory failure" are one of the above groups and the contraindicated disease name is "liver disease with coagulation disorder", the judgment disease name "coagulation disorder" "And" liver disease "are one of the above groups. That is, when a plurality of contraindicated disease names are simply described such as "liver disorder" and "renal disorder" in the package insert of the drug, the unit of any plurality of contraindicated disease names is not the group.

The check level is information for distinguishing the content of the specific process executed based on the determination result of the first determination process or the second determination process in the contraindicated disease name determination process. Specifically, in the specific process, when the check level is set to "high", "disease name contraindication" is displayed, and when the check level is set to "low", " By displaying "Caution for disease name", notification processing with different notification levels is performed. For example, "disease name contraindications" are classified into "errors" that cannot be tolerated by the dispensing support system 10, and "disease name cautions" are "precautions" that are allowed by requiring confirmation instead of "errors" in the contraindicated disease name determination process. It is classified into. In the present embodiment, the check level has two levels of "high" and "low", but as another embodiment, the check level may be three or more levels.

The check group determines whether or not a third determination process for determining whether or not all of the plurality of determination disease name information belonging to one group of the determination disease name information is included in the patient disease name information is executed. Information used to make a judgment. That is, in the third determination process, whether or not all the determination disease names indicated by the plurality of determination disease name information belonging to the same group match any of the patient disease names included in the patient disease name information. Is determined. Further, whether or not the third determination process is executed is determined based not only on the check group but also on the check target flag. Specifically, in the contraindicated disease name determination process, the check target flags of the plurality of determination disease name information are all a group of the plurality of determination disease name information in which the same group identification information is registered in the check group. When it is set to "Yes", the third determination process is executed for the plurality of determination disease name information. In the contraindicated disease name determination process described later, when the group identification information is not registered in the check group corresponding to the drug, the first determination process or the second determination process is executed as necessary. Will be.

When the third determination process is executed in the contraindicated disease name determination process, it is based on the check level set corresponding to each of the determination disease names belonging to the group to be determined in the specific process. The content of the specific process is determined. Specifically, when the check levels corresponding to each of the determination disease names belonging to the group to be determined are all "high", "disease name contraindication" is displayed as the specific process, and the determination target When at least one of the check levels corresponding to each of the determination disease names belonging to the group is "low", it is conceivable that "disease name caution" is displayed as the specific process. As another embodiment, when the third determination process is executed separately from the check level, that is, the setting attribute C described later in which the check group can be set is the specific process in the third determination process. A group check level for distinguishing the contents of the above may be set. In this case, for example, when "high" is set as the group check level, "disease name contraindication" is displayed as the specific process, and when "low" is set as the group check level, the specific process is described. "Caution for disease name" is displayed as a process. As another embodiment, when the third determination process is executed, "disease name contraindication" may be displayed in the specific process regardless of the check level.

The setting attribute is an attribute set in advance to distinguish the contents that can be set as the determination method in the contraindication name determination process (see FIG. 7). Specifically, in the present embodiment, a case where any of the three setting attributes A, B, and C is set as the setting attribute corresponding to the combination of the drug and the determination disease name information will be described as an example. To do.

The setting attribute A sets whether or not the first determination process is executed in the contraindicated disease name determination process and the content of the specific process in the contraindicated disease name determination process for each combination of the drug and the determination disease name information. It is a possible attribute. In particular, among the combinations of the drug and the determination disease name information, with respect to the combination having the same determination disease name information but different drugs, the presence or absence of execution of the first determination process or the content of the specific process is changed for each combination. It is possible. For example, as shown in FIG. 2, among the drugs belonging to the setting attribute A, the contraindicated disease name described in the package insert or the like is “kidney disorder” “drug M1” and the contraindications described in the package insert or the like. Regarding "drug M4", which is a "progressive renal disorder" whose disease name includes the modifier "progressive", the former combination of "drug M1" and "renal disorder" has the above-mentioned check target flag "Yes". , And for the latter combination of "drug M4" and "renal disorder", the check target flag can be set to "none". Further, as shown in FIG. 2, among the drugs belonging to the setting attribute A, the contraindicated disease name described in the package insert or the like is “kidney disorder” “drug M1” and the contraindications described in the package insert or the like. Regarding "drug M2", which is a "serious renal disorder" whose disease name includes the modifier "serious", the above check level is set to "high" for the former combination of "drug M1" and "renal disorder". It is possible to set the check level to "low" for the latter combination of "drug M2" and "renal disorder".

The setting attribute B is a combination of the drug and a part of the determination disease name information selected in advance from a plurality of the determination disease name information belonging to one group of the determination disease name information corresponding to the drug. In addition, it is an attribute that can set whether or not to execute the second determination process in the contraindicated disease name determination process and the content of the specific process in the contraindicated disease name determination process. In the present embodiment, the second determination process is performed only for one determination disease name information selected in advance from a plurality of determination disease name information belonging to one group of the determination disease name information corresponding to the drug. Although the case where is feasible will be described, the second determination process may be feasible for each of the determination disease name information. Specifically, it may be possible to set the check target flag to "Yes" for a plurality of the determination disease name information belonging to one group of the determination disease name information corresponding to the drug.

For example, as shown in FIG. 2, among the drugs belonging to the setting attribute B, there is "drug M11" whose contraindicated disease name described in the package insert or the like is "severe respiratory dysfunction in the acute phase of cerebrovascular accident". In this case, one group of the determination disease name information corresponding to the drug includes "cerebrovascular accident acute phase" and "severe respiratory dysfunction". The contraindicated disease name "acute cerebrovascular accident" is classified as "cerebrovascular accident" in the judgment disease name, and the contraindicated disease name "severe respiratory dysfunction" is "respiratory failure" in the judgment disease name. are categorized. In this case, in the contraindicated disease name master D11, the check target flag is set to "none" for the combination of "drug M11" and "cerebrovascular accident", and the combination of "drug M11" and "respiratory failure" is described above. It is possible to set the check target flag to "Yes". Further, as shown in FIG. 2, in the contraindicated disease name master D11, the check level can be set to "high" or "low" for each combination of the determination disease name information and the drug. The check level may be set to "high" or "low" only for the combination of the determination disease name information in which the check target flag is set to "Yes" and the drug.

The setting attribute C is an attribute capable of setting whether or not to execute the third determination process in the contraindicated disease name determination process and setting the content of the specific process in the contraindicated disease name determination process for each combination of the drug and the group. Is. For example, in the example shown in FIG. 2, group identification information is set for each combination of the drug and the group belonging to the setting attribute C. On the other hand, among the drugs belonging to the setting attribute C, the contraindicated disease name described in the package insert or the like is "drug M21" which is "liver disease with coagulopathy", and the contraindicated disease name described in the package insert or the like is "disease". When "drug M23" which is "disease I4 with I3" is present, the combination of the former "drug M21" and the group including "blood coagulation abnormality" and "liver disease" is group-identified in the check group. It is also possible to set the information and not set the group identification information in the check group for the combination of "drug M23" and the group including "disease I3" and "disease I4".

Further, as shown in FIG. 2, as a drug belonging to the setting attribute C, "disease M22" whose contraindicated disease name described in the package insert or the like is "disease I2 with disease I1" is grouped in the check group. In addition to setting the identification information, it is also possible to set the check target flag corresponding to each of "disease I1" and "disease I2" to "none". When the group identification information is set in the check group, the check target flag may be automatically set to "Yes". Further, as shown in FIG. 2, in the setting attribute C, the check level can be set to "high" or "low" for each combination of the determination disease name information and the drug. The check level may be set to "high" or "low" only for the combination of the drug for which the group identification information is set in the check group and the determination disease name information.

By the way, on the dispensing support system 10, a specific code such as a computer code defined by the Ministry of Health, Labor and Welfare or a standard disease name code defined by a medical institution may be used as identification information for identifying a disease name. .. The name of the determination disease that can be identified by the identification information used on the dispensing support system 10 may be expressed differently from the name of the contraindicated disease. Specifically, the determination disease name may not take into account modifiers such as cause, site, degree, sex, or age of the disease name. For example, as described above, "serious kidney" having different modifiers may not be taken into consideration. "Disorder" and "renal disorder" may be expressed by the same judgment disease name. Therefore, in the contraindicated disease name determination process, the modifier of the contraindicated disease name is not taken into consideration, and the determination accuracy of the contraindicated disease name may decrease. For example, if the patient's disease name is set to be contraindicated when the patient's disease name matches the determination disease name "renal disorder" in the contraindicated disease name determination process, and the patient's disease name is "renal disorder", A drug whose contraindicated disease name is "serious renal disorder" and a drug whose contraindicated disease name is "renal disorder" may be determined to be contraindicated. In this case, a drug that should be determined to be contraindicated only when the modifier is originally "serious" is also determined to be contraindicated, which causes unnecessary confirmation work by the user. On the other hand, as described below, in the dispensing support system 10 according to the present embodiment, it is possible to improve the accuracy of determining the contraindicated disease name of the drug.

Specifically, the control unit 11 of the dispensing support device 1 includes a first processing unit 111, a second processing unit 112, a first setting processing unit 113, a second setting processing unit 114, a third setting processing unit 115, and the like. Includes various processing units. Specifically, the control unit 11 functions as the various processing units by executing various processing according to the contraindication determination program. Further, any one or more of the various processing units may be an electronic circuit such as an ASIC or DSP.

The first processing unit 111 includes the determination disease name information indicating a determination disease name preset in accordance with the drug prescribed to the patient in the patient disease name information indicating the patient's disease name (patient disease name). It is possible to execute the first determination process for determining whether or not the information has been obtained. Specifically, in the first determination process, the first processing unit 111 includes the determination disease name information in the patient disease name information based on the patient master or the prescription data and the contraindicated disease name master D11. Determine if it is. However, the first processing unit 111 executes the first determination process for each combination of the chemicals and the determination disease name information for the combinations having the same determination disease name information but different chemicals. Can be changed based on the setting of the check target flag of the contraindicated disease name master D11.

Further, in the first processing unit 111, a part of the determination disease name information selected in advance from a plurality of the determination disease name information belonging to one group of the determination disease name information corresponding to the drug is the patient. It is also possible to execute the second determination process for determining whether or not the information is included in the disease name information. Specifically, in the second determination process, the first processing unit 111 adds a part of the determination disease name information to the patient disease name information based on the patient master or the prescription data and the contraindicated disease name master D11. Is included or not. However, the first processing unit 111 changes whether or not the second determination process is executed for each combination of the drug and the determination disease name information based on the setting of the check target flag of the contraindicated disease name master D11. Is possible. In particular, in the present embodiment, the first processing unit 111 can execute the second determination processing only for any one of the plurality of determination disease name information belonging to the one group.

Further, the first processing unit 111 determines whether or not a plurality of the determination disease name information belonging to one group of the determination disease name information corresponding to the drug are all included in the patient disease name information. It is also possible to execute the third determination process. Specifically, in the third determination process, the first processing unit 111 adds a plurality of the above belonging to the group to the patient disease name information based on the patient master or the prescription data and the contraindicated disease name master D11. It is determined whether or not all the disease name information for determination is included. However, the first processing unit 111 can change whether or not the third determination process is executed for each combination of the drug and the group based on the setting of the check group of the contraindicated disease name master D11. ..

The second processing unit 112 can execute preset specific processing based on the determination result by the first processing unit 111. Specifically, the specific processing is a notification processing of a determination result by the first processing unit 111. Further, the second processing unit 112 may change the notification content when notifying the determination result to either "disease name contraindication" or "disease name caution" based on the check level of the contraindicated disease name master D11. It is possible. The specific process is not limited to the notification process, and for example, a process of changing whether or not the dispensing operation of the prescription data can be executed by the dispensing device 3 or a question inquiry about the prescription data is made by the higher-level system 6. It may be a process of changing whether or not to automatically transmit to.

The first setting processing unit 113 can set whether or not the first determination process is executed and the content of the specific process corresponding to each combination of the drug and the determination disease name information according to the user operation. is there. The second setting processing unit 114 can set whether or not the second determination process is executed and the content of the specific process corresponding to each combination of the drug and a part of the determination disease name information according to the user operation. is there. The third setting processing unit 115 can set whether or not the third determination process is executed and the content of the specific process corresponding to each combination of the drug and the group according to the user operation. Whether or not the first setting processing unit 113, the second setting processing unit 114, or the third setting processing unit 115 executes the first determination process, the second determination process, or the third determination process. And only one of the contents of the specific process may be set.

[Client terminal 2]
The client terminal 2 is a personal computer including a control unit 21, a storage unit 22, a communication I / F 23, a display device 24, an operation device 25, a drive device 26, and the like. Each of the client terminals 2 is an operation terminal that is arranged in a medical institution where the dispensing support system 10 is used and is operated by a user. The client terminal 2 may be a mobile terminal such as a smartphone or a tablet terminal.

The control unit 21 includes control devices such as a CPU, ROM, RAM, and EEPROM. The CPU is a processor that executes various arithmetic processes. The ROM is a non-volatile storage unit in which information such as a control program for causing the CPU to execute various processes is stored in advance. The RAM is a volatile storage unit, and the EEPROM is a non-volatile storage unit. The RAM and EEPROM are used as a temporary storage memory (working area) for various processes executed by the CPU. Then, the control unit 21 uses the CPU to execute various processes according to various control programs stored in the ROM, the EEPROM, or the storage unit 22 in advance.

The storage unit 22 is a non-volatile storage unit such as a hard disk or SSD that stores various control programs and various data executed by the control unit 21. Specifically, the storage unit 22 includes a program storage unit 221 in which a control program such as an operating system (OS) and browser software is stored. By accessing the dispensing support device 1 via the communication network 5, the browser software causes the display device 24 to display various operation screens and the like, and inputs to the operation screen using the operation device 25. This is a control program for transmitting an operation to the dispensing support device 1. For example, when the control unit 21 inputs address information such as a URL (Universal Resource Locator) corresponding to the dispensing support device 1 at a predetermined position on an operation screen displayed by the browser software, the address information The dispensing support device 1 is accessed based on the above.

The communication I / F 23 wirelessly or wiredly performs data with the dispensing support device 1, the dispensing device 3, and an external device such as the printer 4 via the communication network 5 according to a predetermined communication protocol. It is a communication interface having a network card or the like for executing communication.

The display device 24 is a display unit such as a liquid crystal display or an organic EL display that displays various information according to a control instruction from the control unit 21. The operation device 25 is an operation unit operated by a user to input various information to the client terminal 2. Specifically, the operation device 25 includes a keyboard and a mouse (pointing device) that accept input operations on various operation screens displayed on the display device 24. Further, the operation device 25 may include a touch panel that accepts touch operations on various operation screens displayed on the display device 24, or a voice input device that accepts input of various information by voice recognition.

The drive device 26 can read the OS or the browser software from a computer-readable recording medium 261 on which the OS or the browser software is recorded. The recording medium 261 is a CD, DVD, BD, USB memory, or the like, and the drive device 26 is a CD drive, a DVD drive, a BD drive, a USB port, or the like. In the client terminal 2, the OS or the browser software read from the recording medium 261 by the control unit 21 using the drive device 26 is installed in the program storage unit 221 of the storage unit 22.

In the present embodiment, the server client system is configured by the dispensing support device 1 and the client terminal 2, and the dispensing support device 1 inputs and displays various information according to the user operation of the client terminal 2. , And a case where processing such as printing is executed will be described. That is, the client terminal 2 is used as an operation terminal of the dispensing support device 1, and the "display", "operation", "input" and the like described below are the display device 24 of the client terminal 2 and the said. This is done using the operating device 25.

In the present embodiment, the dispensing support device 1 alone operates as the contraindication determination system according to the present invention, but the client terminal 2 alone may be regarded as the contraindication determination system according to the present invention. For example, a part or all of the contraindication determination program is installed in the client terminal 2, and the control unit 21 of the client terminal 2 appropriately acquires necessary information from the dispensing support device 1 and obtains the present information. It is also conceivable to execute the same processing as the dispensing support device 1 described in the embodiment. Further, the dispensing support device 1 and the client terminal 2 may cooperate to execute the same processing as the dispensing support device 1 described in the present embodiment.

[Contraindication name setting process]
Next, with reference to FIG. 3, the contraindicated disease name setting process executed by the control unit 11 of the dispensing support device 1 will be described. For example, the contraindicated disease name setting process is executed by the control unit 11 when the editing request operation of the contraindicated disease name master D11 is performed on the dispensing support device 1 on the client terminal 2.

<Step S10>
In step S10, the control unit 11 accepts a user operation for selecting a drug (hereinafter, referred to as an edit target drug) to be processed in the contraindicated disease name setting process. For example, the control unit 11 displays a list of drugs registered in the drug master or the contraindicated disease name master D11 as selection candidates of the drug to be edited based on the drug master or the contraindicated disease name master D11. It is displayed on the device 24 and accepts an operation for selecting the drug to be edited from the list.

<Step S11>
In step S11, the control unit 11 is the determination disease name information corresponding to the editing target drug selected in step S10, and is one or more of the determination disease information to be processed in the contraindicated disease name setting process. Accepts user operations for selecting disease name information (hereinafter referred to as editable disease name information). For example, the control unit 11 causes the display device 24 to display a list of the standard disease name or the determination disease name information as a selection candidate of the edit target disease name information based on the disease name master or the contraindicated disease name master D11. An operation for selecting the edit target disease name information from the list is accepted.

If a plurality of combinations of the determination disease name information are registered as the determination disease name information corresponding to the drug to be edited, the control unit 11 has the plurality of contraindicated disease name masters D11. The list of combinations of the determination target disease name information may be displayed on the display device 24 as a selection candidate of the edit target disease name information, and an operation for selecting the edit target disease name information from the list may be accepted. For example, for the combination of the plurality of determination disease name information registered as one group in the contraindicated disease name master D11, the control unit 11 displays the edit target disease name information as a selection candidate on the display device 24 for each group. It may be displayed and an operation for selecting the group from the list may be accepted. Further, when the selected edit target disease name information is not registered in the contraindicated disease name master D11 but is registered in the disease name master, the control unit 11 records a record corresponding to the edit target disease name information. It is added to the contraindicated disease name master D11 in association with the drug to be edited.

<Step S12>
In step S12, the control unit 11 determines whether or not the setting attribute corresponding to the combination of the editing target drug and the editing target disease name information is the setting attribute A based on the contraindicated disease name master D11. .. Here, if it is determined that the setting attribute is the setting attribute A (S12: Yes), the process proceeds to step S13, and if it is determined that the setting attribute is not the setting attribute A (S12: No). ), The process proceeds to step S14.

<Step S13>
In step S13, the control unit 11 receives the check target flag and the check level setting operation for the combination of the edit target drug and the edit target disease name information. Here, the setting process of step S13 is executed by the first setting processing unit 113 of the control unit 11.

For example, the control unit 11 causes the display device 24 to display the first setting screen P11 shown in FIG. On the first setting screen P11, the information of the "drug name" and the "determination disease name" corresponding to the editing target drug and the editing target disease name information is displayed. Further, the control unit 11 has contraindications described in the package insert corresponding to the chemical to be edited on the setting screens such as the first setting screen P11, the second setting screen P12 and the third setting screen P13 described later. The disease name may be displayed based on the drug master. Then, the control unit 11 can accept the check target flag and the check level setting operation corresponding to the edit target drug and the edit target disease name information in response to the user operation using the first setting screen P11. Is. On the first setting screen P11, a pull-down menu area A11 for changing the check target flag to "yes" or "no" and a pull-down menu area for changing the check level to "high" or "low". A12 is displayed. Then, the control unit 11 receives the setting of the check target flag and the check level according to the operation of the pull-down menu areas A11 and A12. After that, the control unit 11 determines the setting contents on the first setting screen P11 in response to the operation of the registration key K11 on the first setting screen P11, and reflects the setting contents on the contraindicated disease name master D11.

<Step S14>
In step S14, the control unit 11 determines whether or not the setting attribute corresponding to the combination of the editing target drug and the editing target disease name information is the setting attribute B based on the contraindicated disease name master D11. .. Here, if it is determined that the setting attribute is the setting attribute B (S14: Yes), the process proceeds to step S15, and if it is determined that the setting attribute is not the setting attribute B (S14: No). ), The process proceeds to step S16.

<Step S15>
In step S15, the control unit 11 sets the check target flag and the check for the combination of the determination target disease name designation operation to be determined in the second determination process, the edit target drug, and the edit target disease name information. Accepts level setting operations. Here, the setting process of the step S15 is executed by the second setting processing unit 114 of the control unit 11.

For example, the control unit 11 causes the display device 24 to display the second setting screen P12 shown in FIG. On the second setting screen P12, the information of the "drug name" and the "determination disease name" corresponding to the edit target drug and a plurality of the edit target disease name information belonging to one group corresponding to the edit target drug is displayed. ing. Further, on the second setting screen P12, the pull-down menu areas A11 and A12 are displayed in the same manner as the first setting screen P11.

Then, on the second setting screen P12, a radio button area A13 for selectively selecting a part of the edit target disease name information from the plurality of edit target disease name information is displayed. The control unit 11 selects a part of the edit target disease name information according to the user operation of the radio button area A13. After that, the control unit 11 responds to the user operation using the pull-down menu areas A11 and A12 of the second setting screen P12, and corresponds to the combination of the editing target drug and the part of the editing target disease name information. It is possible to accept the check target flag and the check level setting operation. After that, the control unit 11 determines the setting contents on the second setting screen P12 in response to the operation of the registration key K11 on the second setting screen P12, and reflects the setting contents on the contraindicated disease name master D11. .. The control unit 11 sets the check target flag to "none" for the edit target disease name information that has not been selected from the plurality of edit target disease name information displayed in the radio button area A13. Further, the pull-down menu areas A11 and A12 are displayed for each of the plurality of edit target disease names as in the third setting screen P12 described later, and the check target flag and the check level can be set for each edit target disease name. You may.

<Step S16>
In step S16, the control unit 11 determines whether or not the setting attribute corresponding to the combination of the editing target drug and the editing target disease name information is the setting attribute C based on the contraindicated disease name master D11. .. Here, if it is determined that the setting attribute is the setting attribute C (S16: Yes), the process proceeds to step S17, and if it is determined that the setting attribute is not the setting attribute C (S16: No). ), The contraindicated disease name setting process is completed.

<Step S17>
In step S17, the control unit 11 receives a setting operation of the check target flag, the check level, and the check group for the combination of the edit target drug and the edit target disease name information. Here, the setting process of step S17 is executed by the third setting processing unit 115 of the control unit 11.

For example, the control unit 11 causes the display device 24 to display the third setting screen P13 shown in FIG. On the third setting screen P13, the information of the "drug name" and the "determination disease name" corresponding to the edit target drug and a plurality of the edit target disease name information belonging to one group corresponding to the edit target drug is displayed. ing. Further, on the third setting screen P13, the pull-down menu areas A11 and A12 are displayed corresponding to each of the editing target disease name information. Then, the control unit 11 responds to the user operation using the pull-down menu areas A11 and A12 of the third setting screen P13, and the check target corresponding to each combination of the edit target drug and the edit target disease name information. It is possible to accept the flag and the check level setting operation. As another embodiment, on the third setting screen P13, the check target flag and the check level setting operation corresponding to each combination of the edit target drug and the edit target disease name information cannot be accepted, and the operation is not accepted. It may be possible to collectively accept the check target flag and the check level setting operations for a plurality of combinations of the edit target drug and the edit target disease name information.

Further, on the third setting screen P13, a pull-down menu area A14 for setting whether or not to consider the simultaneous occurrence of the plurality of editable disease name information is displayed. Then, the control unit 11 accepts selection of whether or not to determine whether or not a plurality of the edit target disease name information are co-occurring in response to the operation of the pull-down menu area A14.

After that, the control unit 11 determines the setting contents on the third setting screen P13 in response to the operation of the registration key K11 on the third setting screen P13, and reflects the setting contents on the contraindicated disease name master D11. .. In particular, the control unit 11 sets "Yes" to determine whether or not the plurality of edit target disease name information are co-occurred in response to the operation of the pull-down menu area A14 corresponding to the co-occurrence of the plurality of edit target disease name information. If so, any group identification information is assigned to the plurality of edit target disease name information, and the group identification information is registered as "check group" information corresponding to each of the edit target disease name information. The control unit 11 may accept an arbitrary input operation of the group identification information by the user.

As described above, in the contraindicated disease name setting process, the range that can be set for the determination method differs depending on the setting attribute corresponding to each combination of the drug and the determination disease name information, for example, the setting attribute A or The check group cannot be set for the combination of the drug belonging to the setting attribute B and the determination disease name information.

[Contraindicated disease name determination process]
Next, with reference to FIG. 7, the contraindicated disease name determination process executed by the control unit 11 of the dispensing support device 1 will be described. For example, the contraindicated disease name determination process includes the timing when the dispensing support device 1 receives the prescription data, the timing before the dispensing support device 1 transmits a dispensing start instruction to the dispensing device 3 for the prescription data, or the timing. The control unit 11 executes the execution request operation of the contraindicated disease name determination process for the prescription data at an arbitrary timing such as a timing performed by the user. Hereinafter, the prescription data that is the target of the contraindicated disease name determination process will be referred to as a target prescription data. The contraindicated disease name determination process is performed on various check items such as "interaction", "overlap (same drug effect, same drug, same ingredient)", "dose", "combination change", and "contraindicated disease name". It is executed as a part of the prescription check process for determining the suitability of the target prescription data, but here, only the contraindicated disease name determination process is described, and in the prescription check process, the process for determining the suitability of other check items is performed. The explanation is omitted.

Further, in the present embodiment, the patient disease name information is included in at least one of the target prescription data or the patient master, and the control unit 11 acquires the patient disease name information from the target prescription data or the patient master. It is possible. When both the target prescription data and the patient master include the patient disease name information, the control unit 11 acquires the patient disease name information of the target prescription data or the patient master whose update date is newer. Alternatively, the patient disease name information included in the target prescription data may be acquired in preference to the patient master. The control unit 11 displays a display screen for prompting the input of the patient disease name information when the patient disease name information cannot be acquired for the patient of the target prescription data, and the patient disease name information is received according to the user input. May be obtained.

<Step S20>
In step S20, each time the step S20 is executed, the control unit 11 selects a drug to be processed for the contraindicated disease name determination process from the drug included as the prescription drug in the target prescription data (hereinafter, the drug to be determined). ) Are selected one by one.

<Step S21>
In step S21, each time the step S21 is executed, the control unit 11 obtains the determination disease name information from one or more of the determination disease name information registered in association with the determination target drug in the contraindicated disease name master D11. The determination disease name information (hereinafter, referred to as target determination disease name information) to be determined in the contraindicated disease name determination process is selected in order. In the present embodiment, the case where the determination disease name information is selected first and it is determined whether or not the determination disease name information is included in the patient disease name information will be described, but the patient disease name information is first. It may be determined whether or not the patient disease name information is included in the determination disease name information of the determination target drug.

<Step S22>
In step S22, the control unit 11 determines whether or not the group identification information is set in the check group corresponding to the combination of the determination target drug and the target determination disease name information based on the contraindicated disease name master D11. To judge. Here, if it is determined that the group identification information is set in the check group (S22: Yes), the process proceeds to step S221, and it is determined that the group identification information is not set in the check group. If so (S22: No), the process proceeds to step S24.

<Step S221>
In step S221, the control unit 11 determines whether or not the check target flag corresponding to all the determination disease name information belonging to the check group is set to "Yes". Here, when it is determined that all the check target flags are set to "Yes" (S221: Yes), the process proceeds to step S23, and any of the check target flags is set to "None". If it is determined that this is done (S221: No), the process proceeds to step S29.

<Step S23>
In step S23, in the control unit 11, the patient whose target determination disease name information belongs to one group in which the same group identification information is set in the check group corresponds to the target prescription data. The third determination process for determining whether or not all of the disease name information is included is executed. That is, the control unit 11 determines whether or not all the determination disease names indicated by the plurality of target determination disease name information belonging to the same group match any of the patient disease names included in the patient disease name information. Is determined. In this case, it is assumed that the other determination disease name information belonging to the same group as the target determination disease name information selected in step S21 has already been selected as the target determination disease name information, and the step S21 and the following will be described later. The determination in step S29 of step S29 is executed. The third determination process is an example of the first step according to the present invention, and is executed by the first process unit 111 of the control unit 11. Here, when it is determined that the plurality of target determination disease name information is all included in the patient disease name information (S23: Yes), the process proceeds to step S26, and the process proceeds to step S26 of the plurality of target determination disease name information. If it is determined that there is something that is not included in the patient disease name information (S23: No), the process proceeds to step S29. As described above, in the present embodiment, a plurality of the determination disease names belonging to the group are selected first, and in the third determination process, the plurality of determination disease name information are all included in the patient disease name information. A case where it is determined whether or not it is included will be described. On the other hand, as another embodiment, after each of the patient disease names included in the patient disease name information is selected first and it is determined whether or not each of the patient disease names corresponds to any of the determination target disease names. In the third determination process, it may be determined whether or not the patient disease name information includes all of the plurality of determination disease name information belonging to the group.

<Step S24>
In step S24, the control unit 11 determines whether or not the check target flag corresponding to the combination of the determination target drug and the target determination disease name information is set to "Yes" based on the contraindicated disease name master D11. To judge. Here, if it is determined that the check target flag is set to "Yes" (S24: Yes), the process proceeds to step S25, and it is determined that the check target flag is set to "None". If so (S24: No), the process proceeds to step S29.

<Step S25>
In step S25, the control unit 11 executes a determination process for determining whether or not the target determination disease name information is included in the patient disease name information. More specifically, when the target determination disease name information corresponding to the determination target drug does not belong to the group, the control unit 11 includes the determination disease name information in the patient disease name information. The first determination process for determining whether or not to perform is executed. That is, in the first determination process, the control unit 11 determines whether or not the determination disease name indicated by the determination disease name information matches any of the patient disease names included in the patient disease name information. It will be. On the other hand, when the target determination disease name information corresponding to the determination target drug is a part of a plurality of target determination disease name information belonging to one group, the control unit 11 is a part of the target. The second determination process for determining whether or not the determination disease name information is included in the patient disease name information is executed. That is, in the second determination process, the control unit 11 has the determination disease name indicated by a part of the determination disease name information selected in advance from the plurality of determination disease name information belonging to the same group. It will be determined whether or not the information matches any of the patient disease names included in the patient disease name information. The first determination process and the second determination process are examples of the first step according to the present invention, and are executed by the first processing unit 111 of the control unit 11. Here, when it is determined that the patient disease name information includes the target determination disease name information (S25: Yes), the process proceeds to step S26, and the patient disease name information includes the target determination disease name information. If it is determined that there is no such procedure (S25: No), the process proceeds to step S29. As described above, in the present embodiment, the determination disease name information is selected first, and it is determined in the determination process whether or not the determination disease name information is included in the patient disease name information. However, the patient disease name information may be selected first, and it may be determined in the determination process whether or not the patient disease name information is included in the determination disease name information of the determination target drug.

<Step S26>
In step S26, the control unit 11 determines whether or not the check level is "high" based on the contraindicated disease name master D11. Specifically, when it is determined in the third determination process in step S23 that the patient disease name information includes all of the plurality of target determination disease name information, all the target determination disease names are determined. It is determined whether or not the check level corresponding to the information is "high". If it is determined in the first determination process or the second determination process in step S25 that the patient disease name information includes the target determination disease name information, the target determination disease name information is determined. It is determined whether or not the check level corresponding to is "high". Here, when it is determined that the check level is "high" (S26: Yes), the process proceeds to step S27, and when it is determined that the check level is "low" (S26: No). , The process proceeds to step S28. For example, when the third determination process in step S23 is executed, the process shifts to step S27 when the check level corresponding to all the target determination disease name information is “high”, and the process proceeds to step S27. If the check level corresponding to any of the target determination disease name information is "low", the process proceeds to step S28.

<Step S27>
In step S27, the control unit 11 sets the notification information of the first aspect set in advance to be notified to the patient as the determination result by the first processing unit 111 in step S31 described later. Specifically, the control unit 11 stores the information indicating that "disease name contraindication" has occurred in the determination target drug in the storage unit 12 as the notification information of the first aspect. For example, the notification information includes information that the determination result is a disease name contraindication, the determination target drug that caused the "disease name contraindication", the determination disease name information, the patient disease name information, and the like. .. Further, the control unit 11 may set the notification information including the contraindicated disease name described in the package insert corresponding to the determination target drug based on the drug master.

<Step S28>
In step S28, the control unit 11 sets preset second-mode notification information to be notified to the patient as a determination result by the first processing unit 111 in step S31 described later. Specifically, the control unit 11 stores in the storage unit 12 information indicating that "disease name caution" has occurred for the determination target drug as the notification information of the second aspect. For example, the notification information includes information that the determination result is a disease name caution, the determination target drug that caused the "disease name caution", the determination disease name information, the patient disease name information, and the like. .. Further, the control unit 11 may set the notification information including the contraindicated disease name described in the package insert corresponding to the determination target drug based on the drug master. As described above, in the steps S26 to S28, the notification information notified as the determination result in the step S31 described later is changed based on the check level.

<Step S29>
In step S29, the control unit 11 determines whether or not the processing for all the determination disease name information corresponding to the determination target drug has been completed. Specifically, it is determined in step S21 whether or not all the determination disease name information corresponding to the determination target drug has been selected as the target determination disease name information. Here, when it is determined that the processing for all the determination disease name information has been completed (S29: Yes), the processing proceeds to step S30. On the other hand, when it is determined that the processing for all the determination disease name information has not been completed (S29: No), the processing is returned to the step S21, and the next determination disease name information is used for the target determination. It is selected as the disease name information, and the processes after step S22 are executed. As another embodiment, in the contraindicated disease name master D11, the determination method for the combination of the drug and the determination disease name information can be registered in both the setting attribute B and the setting attribute C, respectively. In this case, the control unit 11 may execute both the third determination process in the step S23 and the second determination process in the step S25.

<Step S30>
In step S30, the control unit 11 determines whether or not the processing for all the prescription drugs included in the target prescription data has been completed. Specifically, in step S20, it is determined whether or not all the prescription drugs included in the target prescription data have been selected as the determination target drugs. Here, when it is determined that the processing for all the prescription drugs has been completed (S30: Yes), the processing proceeds to step S31. On the other hand, when it is determined that the treatments for all the prescription drugs have not been completed (S30: No), the treatment is returned to the step S20, and the next prescription drug is selected as the determination target drug. The processes after step S21 are executed.

<Step S31>
In step S31, the control unit 11 executes a notification process for notifying the determination result by the first processing unit 111. The notification process is an example of the specific process in the present invention. Specifically, the control unit 11 notifies the user by displaying the determination result on the display device 24. In particular, the control unit 11 notifies the notification information of the first aspect or the notification information of the second aspect set in step S27 or step S28 as the notification result. That is, the control unit 11 can change the notification content of the determination result according to the combination of the drug and the determination disease name information. The method for notifying the determination result is not limited to display, and the determination result may be notified to the user by printing by the printer 4, and the determination result is transmitted to a preset mobile terminal or the like to the user. May be notified to.

8 to 11 are views showing an example of the notification screen P21 when the determination result is displayed on the display device 24. After referring to the determination result, the notification screen P21 displays various operation keys for accepting responses such as "approval", "question schedule", and "question inquiry" by the user. Further, the notification screen P21 may display the determination results of other check items included in the prescription check process, but the description thereof will be omitted here. Further, the control unit 11 may display the contraindicated disease name described in the package insert corresponding to the determination target drug on the notification screen P21 shown in FIGS. 8 to 11 based on the drug master. Good.

The notification screen P21 of FIG. 8 is a case where it is determined by the first determination process or the second determination process that the patient disease name information includes the determination disease name information, and the determination target drug and the determination It shows the determination result when the check level corresponding to the combination of the disease name information is set to "high". In this case, "disease name contraindication" is displayed as the determination result on the notification screen P21, and the error message "the patient's disease name matches" renal disorder "which is the contraindicated disease name of" drug M1 ". A message is displayed notifying that a "disease name contraindication" error has occurred.

Further, the notification screen P21 of FIG. 9 is a case where it is determined by the first determination process or the second determination process that the patient disease name information includes the determination disease name information, and the determination target drug and the determination target drug and the determination target drug It shows the judgment result when the check level corresponding to the combination of the judgment disease name information is set to "low". In this case, "Caution for disease name" is displayed as the determination result on the notification screen P21, and "Patient disease name may match" Serious renal disorder "which is a contraindicated disease name of" Drug M2 "as a confirmation message. Be careful because it has sex. A message is displayed to inform that the confirmation item of "Caution for disease name" such as "" has occurred.

As described above, in the dispensing support system 10 according to the present embodiment, even when the patient disease name information includes the determination disease name information, each combination of the determination disease name information and the determination target drug is performed. , The content of the specific process can be changed. For example, it is possible to change the content of the specific processing based on the correspondence between the contraindicated disease name and the drug for contraindicated disease names having different modifiers indicating the degree of integration as one of the determination disease name information. Yes, it is possible to improve the accuracy of determination of contraindicated disease names. As a result, for example, the contraindications to the disease name are not unnecessarily notified, and the labor of unnecessary confirmation work by the user is reduced.

Further, in the dispensing support system 10 according to the present embodiment, regarding the drug to be determined, only a part of the determination disease name information in one group including a plurality of the determination disease name information is contraindicated in the disease name or cautioned. It is possible to determine the presence or absence of the disease name, and not to determine the presence or absence of the disease name contraindication or the disease name caution for the other determination disease name information. As a result, as compared with the case where the presence or absence of the disease name contraindication or the disease name caution is individually determined for all the determination disease name information included in the group, the disease name contraindication or the disease name caution is not unnecessarily notified by the user. The time and effort required for unnecessary confirmation work is reduced.

The notification screen P21 of FIG. 10 is a case where it is determined by the third determination process that the patient disease name information includes all of the plurality of determination disease name information belonging to one group, and all the determination targets. It shows the determination result when the check level corresponding to the combination of the drug and the determination disease name information is set to "high". In this case, "disease name contraindication" is displayed as the determination result on the notification screen P21, and "patient disease name combination is contraindicated disease name of" drug M21 "" blood coagulation abnormality "," liver disease "as an error message. Matches the combination of. A message is displayed notifying that a "disease name contraindication" error has occurred.

Further, the notification screen P21 of FIG. 11 is a case where it is determined by the third determination process that the patient disease name information includes all of the plurality of determination disease name information belonging to one group, and any one of them. It shows the determination result when the check level corresponding to the combination of the determination target drug and the determination disease name information is set to "low". In this case, on the notification screen P21, "disease name caution" is displayed as the determination result, and as a confirmation message, "the combination of patient disease names is the contraindicated disease name of" drug M21 "," blood coagulation abnormality ", and" liver disease ". Please note that it may match the combination of. A message is displayed to inform that the confirmation item of "Caution for disease name" such as "" has occurred.

As described above, in the dispensing support system 10 according to the present embodiment, the third determination for determining the presence or absence of disease name contraindications or disease name caution in one group unit including a plurality of the determination disease name information for the determination target drug. In the treatment, it is possible to change whether or not to determine the presence or absence of disease name contraindications or disease name caution for each group. As a result, for example, when only a part of the judgment disease name information included in the group is included in the patient disease name information, the disease name contraindication or the disease name caution is wasted as compared with the case where the disease name contraindication or the disease name caution is determined. It is not notified, and the trouble of unnecessary confirmation work by the user is reduced.

As shown in FIGS. 8 to 11, on the notification screen P21, the determination is made depending on whether the determination result by the contraindicated disease name determination process is "disease name contraindication" or "disease name caution". The display mode such as the background color or the character color of the result display area may be different.

By the way, when the control unit 11 does not execute the step S23 in the contraindicated disease name determination process, or when it is not determined in the step S23 that the patient disease name information includes all the determination disease name information. If the step S25 is not executed, or if it is not determined in the step S25 that the patient disease name information includes the determination disease name information, the disease name contraindication and the disease name caution occur in the step S31. It is conceivable that the notification result is displayed on the notification screen P21, or the determination result is not notified (the notification screen P21 is not displayed).

Further, in the present embodiment, the configuration in which the determination method corresponding to each combination of the drug and the determination target disease name information can be individually set in the contraindicated disease name master D11 has been described as an example. On the other hand, as another embodiment, in the dispensing support system 10, the contraindicated disease name master D11 and the exception master that defines an exception to the determination method are stored in the storage unit 12, and these masters store the contraindicated disease name determination. It may be the configuration used in the process. Specifically, in the contraindicated disease name master D11, the basic determination method corresponding to each of the drugs is registered in advance. On the other hand, the control unit 11 sets the determination method as an exception for any combination of the drug and the determination target disease name information registered in the contraindicated disease name master D11 according to the user operation. Is accepted, and the content of the determination method is registered in the exception master. Then, in the contraindicated disease name determination process, the control unit 11 processes the combination of the drug registered in the exception master and the determination target disease name information according to the determination method registered in the exception master. For the combination of the drug and the determination target disease name information not registered in the exception master, the process is executed according to the determination method registered in the contraindicated disease name master D11. As a result, for example, while using the conventionally used contraindicated disease name master D11, it is possible to change whether or not the determination process is executed and the content of the specific process for each combination of the drug and the determination disease name information. It is possible.

Further, in the present embodiment, as the contraindication determination system according to the present invention, the dispensing support system 10 used for supporting the dispensing work by a pharmacist has been described as an example. On the other hand, instead of the dispensing support system 10, even if the electronic medical record system capable of registering the patient's medical examination record and prescription contents in the electronic medical record according to the operation of a user such as a doctor is the contraindication determination system according to the present invention. Good. In this case, when a control unit such as a computer included in the electronic medical record system performs a user operation for registering a medical examination record or a prescription content corresponding to the patient in the electronic medical record, the above-mentioned corresponding to the patient. The contraindicated disease name determination process (FIG. 7) is executed with the prescription data as the processing target.

[Other examples of contraindication judgment processing]
In the contraindicated disease name determination process, a case where the first determination process or the second determination process is executed as necessary when the group identification information is not registered in the check group corresponding to the drug will be described. did. On the other hand, as another embodiment, even when the group identification information is registered in the check group corresponding to the drug in the contraindicated disease name determination process, the first determination process or the said The configuration may be such that the second determination process can be executed. Specifically, if it is determined in step S221 that any of the check target flags is set to "none" (S221: No), it is conceivable that the process shifts to step S24. Then, when it is determined in step S24 that the check target flag is set to "Yes" for the determination disease name information (S24: Yes), the determination disease name information is obtained in step S25. A determination process is executed in which the determination as to whether or not the information is included in the patient disease name information is executed. In this case, in step S26, the process is branched based on the check level corresponding to the determination disease name information determined to be included in the patient disease name information (S26: Yes or No). Further, in this case, it is assumed that the other determination disease name information belonging to the same group as the target determination disease name information selected in step S21 is not selected as the target determination disease name information thereafter. The determination of step S21 described above and step S29 described later is executed. As a result, even when the check group is set, it is possible to individually determine the contraindications for each of the determination disease name information as needed.

[External agent site determination function]
By the way, it is conceivable that the drug to be treated in the contraindicated disease name determination process is an external preparation to be applied or attached to a specific site of the patient. In this case, the judgment of whether or not the disease name is contraindicated or the disease name should be noted may differ depending on the site where the external preparation is used. For example, when the disease occurring in a patient to whom an external preparation is prescribed is "second-degree deep burn" for the "hand", the disease develops only in a specific injured site. Consider the case. In this case, if the judgment target disease name information corresponding to the external preparation is "second-degree deep burn or higher", the disease name is contraindicated or even if the purpose of use of the external preparation is not the damaged site. It will be judged that the name of the disease should be noted.

Therefore, with respect to the external preparation, it may be necessary to consider the site where the external preparation is used when determining the disease name contraindication or the disease name caution based on the determination disease name information. Therefore, the dispensing support system 10 may determine a disease name contraindication or a disease name caution only for a specific part of a drug, and for a specific external preparation, a disease name based on the determination disease name information corresponding to the specific external preparation. It is conceivable to have an external preparation site determination function that can consider the site of use of the specific external preparation when determining contraindications or cautions regarding the name of the disease. Specifically, in the contraindicated disease name master D11, it is considered that a site confirmation flag can be set for the combination of the specific external preparation and the determination disease name information. For example, when the determination disease name information is a disease name such as "cerebral hemorrhage" in which the determination result of the disease name contraindication or the disease name caution is the same depending on the site where the external preparation is used, "0" indicating that fact is displayed. It is set as the site confirmation flag. On the other hand, the judgment result of the disease name information for judgment may differ depending on the site where the external preparation is used, such as "second-degree deep burn" or "shingles". In the case of, "1" indicating to that effect is set as the site confirmation flag.

Then, in step S26, if the check level is "high" but the site confirmation flag is "1", the control unit 11 may shift the process to step 28. Be done. In this case, in step S28, the notification information is set so that a message indicating that the external preparation corresponds to a disease name contraindication depending on the site of use of the patient is displayed. As a result, when the purpose of use of the external preparation is not the damaged site, it is possible not to determine that the disease name is contraindicated, and the labor of unnecessary confirmation work by the user can be reduced.

When the damaged site is registered in the patient master or the patient disease name information registered in the prescription data or the like, and the site where the external preparation is used is registered in the prescription data, the control unit 11 However, based on the patient disease name information and the determination disease name information, it is determined that the disease name is contraindicated when the damaged site and the used site match, and the disease name is contraindicated when the damaged site and the used site do not match. It is possible not to do so.

1: Dispensing support device 11: Control unit 12: Storage unit 13: Communication I / F
14: Display device 15: Operation device 16: Drive device 2: Client terminal 21: Control unit 22: Storage unit 23: Communication I / F
24: Display device 25: Operation device 26: Drive device 3: Dispensing device 4: Printer 10: Dispensing support system

Claims (15)

The first determination process for determining whether or not the patient disease name information indicating the patient's disease name includes the determination disease name information indicating the determination disease name preset corresponding to the drug prescribed to the patient is executed. Possible first processing unit and
A second processing unit capable of executing preset specific processing based on the determination result by the first processing unit, and
With
Among the combinations of the drug and the determination disease name information, for a combination having the same determination disease name information but different drugs, the presence or absence of execution of the first determination process or the content of the specific process can be changed for each combination. is there,
Contraindication judgment system. The specific process is a process for notifying the determination result by the first processing unit when it is determined that the patient disease name information includes the determination disease name information.
The second processing unit can change the notification content of the specific processing for each combination.
The contraindication determination system according to claim 1. It is provided with a first setting processing unit that sets whether or not to execute the first determination process or the content of the specific process corresponding to each combination of the drug and the determination disease name information according to a user operation.
The contraindication determination system according to claim 1 or 2. The determination disease name information is information in which a plurality of contraindicated disease names having the same type of disease name but different modifiers of the disease name are integrated.
The contraindication determination system according to any one of claims 1 to 3. In the first processing unit, a part of the determination disease name information selected in advance from a plurality of the determination disease name information belonging to one group of the determination disease name information corresponding to the drug is used as the patient disease name information. It is possible to execute the second determination process for determining whether or not it is included.
Whether or not the second determination process is executed or the content of the specific process can be changed for each combination of the drug and the determination disease name information.
The contraindication determination system according to any one of claims 1 to 4. It is provided with a second setting processing unit capable of setting whether or not to execute the second determination process or the content of the specific process corresponding to each combination of the drug and a part of the determination disease name information according to a user operation.
The contraindication determination system according to claim 5. The first processing unit determines whether or not a plurality of the determination disease name information belonging to one group of the determination disease name information corresponding to the drug are all included in the patient disease name information. The process can be executed and
Whether or not the third determination process is executed or the content of the specific process can be changed for each combination of the drug and the group.
The contraindication determination system according to any one of claims 1 to 6. It is provided with a third setting processing unit capable of setting whether or not the third determination process is executed or the content of the specific process corresponding to each combination of the chemical and the group according to a user operation.
The contraindication determination system according to claim 7. In the patient disease name information indicating the patient's disease name, a plurality of the determination disease name information belonging to one group of the judgment disease name information indicating the judgment disease name preset corresponding to the drug prescribed to the patient is previously selected. A first processing unit capable of executing a second determination process for determining whether or not a part of the selected disease name information for determination is included, and
A second processing unit capable of executing preset specific processing based on the determination result by the first processing unit, and
With
Whether or not the second determination process is executed or the content of the specific process can be changed for each combination of the drug and a part of the determination disease name information.
Contraindication judgment system. In the patient disease name information indicating the patient's disease name, all of the plurality of the determination disease name information belonging to one group among the judgment disease name information indicating the determination disease name preset corresponding to the drug prescribed to the patient are all. A first processing unit capable of executing a third determination process for determining whether or not it is included, and
A second processing unit capable of executing preset specific processing based on the determination result by the first processing unit, and
With
Whether or not the third determination process is executed or the content of the specific process can be changed for each combination of the drug and the group.
Contraindication judgment system. To the processor
The first determination process for determining whether or not the patient disease name information indicating the patient's disease name includes the determination disease name information indicating the determination disease name preset corresponding to the drug prescribed to the patient is executed. The first step to do and
A second step capable of executing a preset specific process based on the determination result of the first step, and
It is a contraindication judgment program to execute
Among the combinations of the drug and the determination disease name information, for a combination having the same determination disease name information but different drugs, the presence or absence of execution of the first determination process or the content of the specific process can be changed for each combination. is there,
Contraindication judgment program. To the processor
In the patient disease name information indicating the patient's disease name, a plurality of the determination disease name information belonging to one group of the judgment disease name information indicating the judgment disease name preset corresponding to the drug prescribed to the patient is previously selected. The first step of executing the second determination process of determining whether or not a part of the selected disease name information for determination is included, and
A second step capable of executing a preset specific process based on the determination result of the first step, and
It is a contraindication judgment program to execute
Whether or not the second determination process is executed or the content of the specific process can be changed for each combination of the drug and a part of the determination disease name information.
Contraindication judgment program. To the processor
In the patient disease name information indicating the patient's disease name, all of the plurality of the determination disease name information belonging to one group among the judgment disease name information indicating the determination disease name preset corresponding to the drug prescribed to the patient are all. The first step of executing the third determination process of determining whether or not it is included, and
A second step capable of executing a preset specific process based on the determination result of the first step, and
It is a contraindication judgment program to execute
Whether or not the third determination process is executed or the content of the specific process can be changed for each combination of the drug and the group.
Contraindication judgment program. The processor determines whether or not the patient disease name information indicating the patient's disease name includes the determination disease name information indicating the determination disease name preset according to the drug prescribed for the patient. It is a contraindicated disease name database used when executing and executing a preset specific process based on the determination result of the determination process.
Among the combinations of the drug and the determination disease name information, for the combination having the same determination disease name information but different drugs, it is possible to set whether or not the determination process is executed or the content of the specific process for each combination.
Based on the contraindicated disease name database, the processor can change whether or not the determination process is executed or the content of the specific process for each combination of the drug and the determination disease name information.
Contraindicated disease name database. The determination disease name information is information in which a plurality of contraindicated disease names having the same type of disease name but different modifiers of the disease name are integrated.
The contraindicated disease name database according to claim 14.

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