JP5253605B2 - Drug interaction check system - Google Patents

Description

  The present invention relates to a drug interaction check system used for prescription audit work and prescription design work in medical facilities such as hospitals and dispensing pharmacies.

  Traditionally, in a prescription ordering system that runs on a host computer such as a hospital, when a doctor instructs the prescription of a drug to be administered to a patient and inputs the prescription data, the interaction between the drugs, that is, the efficacy of the drug is offset It is done to check that it is done.

  In Patent Document 1, the interaction between a plurality of medicines is checked with reference to the contraindicated relationship between the medicine constituents registered in the first information and the medicine components registered in the second information. The incompatibility check method is described.

  In Patent Document 2, there is a combination in which an interaction occurs due to the efficacy of each drug having overlapping dosing periods between the medicine and dosing period instructed this time and the drugs and dosing periods previously ordered for the same patient. A medicine ordering system that determines whether or not to output a warning is described.

  Patent Document 3 describes a chart that uses symbols or characters indicating the content of the interaction in a plurality of intersecting cells for entering the interaction between substances.

  Patent Document 4 discloses a drug interaction rule creation device in which the first 7 digits of the drug price listed in the drug price standard set by the Ministry of Health and Welfare are used as the drug efficacy code, and the combination of the drug efficacy and the check result are expressed by an IF-THEN rule. Is described.

  Patent Document 5 includes a plurality of codes such as a receipt computer processing system master code, a generic name code representing an ingredient, and a medicinal effect classification code as drug data. • A device for checking drug interactions that displays mechanism data is described.

  However, in any of the above, the focus is on checking the interaction between pharmaceuticals, and the display content is merely a simple one such as “A pharmaceutical and B pharmaceuticals are contraindicated in combination”. Therefore, it is not sufficient for a pharmacist for analyzing the details of prescription data, such as auditing the entire prescription including past prescription data of the same patient, or examining alternatives to inconvenient drugs. In this case, simply displaying the contents of the interaction check is complicated and difficult to see, and is not practical.

  In any of the conventional examples, it is impossible to display the interaction data results in a format corresponding to each medical facility. In addition, when the interaction is checked for all pharmaceuticals, many combinations of precautions are generated, and the display becomes very difficult to see.

  In particular, a drug with a problem in the interaction check result must be replaced with another drug, but no measures are taken for that purpose.

JP-A-8-57021 Japanese Patent Laid-Open No. 8-315040 Japanese Patent Laid-Open No. 10-166760 JP 11-47238 A JP-A-11-195078

It is an object of the present invention to provide a drug interaction check system and a program that can display a check result of a drug interaction in a practically easily understandable manner.

As a means for solving the above problems, the present invention provides:
Drug interaction check system
To any device connected to the network,
Mutually storing combinations in which interactions occur in two types of master-slave relationships: the case of one other medicine seen from one medicine and the one medicine seen from the other one medicine Storage means for storing an action master;
Each drug in the new prescription data entered is self-drug and partner drug, and it is determined whether or not the combination of self-drug and partner drug matches the drug combination registered in the interaction master. Control means for executing the check process;
The result of the interaction check process by the control means displays the name of the target self-medication and the name of the partner drug to be the target of the interaction check process in a matrix-type row or column, respectively. Display means for displaying the result of the interaction check process between the medicines in each corresponding cell of the matrix format;
It is set as the structure provided with.

  With this configuration, it is possible to display the interaction between the new prescription data and the stored prescription data so as to be grasped at a glance.

  The interaction master stored in the storage means preferably stores the combination in which the interaction occurs as a combination of medicinal efficacy codes that define the efficacy of each drug.

The storage means further stores an action master in which detailed information including an action / mechanism is associated with each combination of pharmaceuticals in which an interaction occurs.
When each cell in which the result of the interaction check process is displayed is designated, the control means causes the display means to display detailed information about the interaction based on the action master stored in the storage means. Is preferred.

The storage means further stores accumulated prescription data obtained by accumulating past prescription data including patient data,
The partner drug preferably includes each drug in the stored prescription data.

  The display means displays the name of the self-medication and the name of the partner drug in a matrix row or column, respectively, when the partner drug is each drug of the new prescription data, and when the partner drug is each drug of the accumulated prescription data. Displaying in a switchable manner in some cases is preferable in that the display screen can be prevented from becoming complicated.

  It is preferable that the result of the interaction check displayed in each cell of the matrix format displayed on the display means includes the combined use warning and the combined contraindication displayed by distinguishable symbols.

The display means includes a drug addition button that allows a new medicine to be additionally displayed in addition to each medicine of the new prescription data in the matrix format screen to be displayed.
The control means, when the medicine addition button is operated, in the matrix format screen displayed on the display means, in the row or column where the name of each medicine of the new prescription data is displayed, the name of the new medicine It is preferable to recheck the interaction between the self-pharmaceutical and the partner drug that has been additionally displayed.

The storage means stores an interaction exclusion master that stores a combination of medicines that excludes an interaction check process among combinations of medicines that generate an interaction registered in the interaction master,
The control means, after executing the interaction check process based on the interaction master, after searching the interaction exclusion master and excluding the corresponding combination of medicines, it is possible to display only the interactions with high importance Is preferable.

The storage means stores an interaction individual master created according to each medical facility separately from an interaction common master that stores data on a combination of medicines in which an interaction occurs.
The control means preferably executes an interaction check process based on the interaction individual master in preference to the interaction common master.

  As is clear from the above description, according to the present invention, the interaction check result is displayed in a matrix format of each drug in the new prescription data and each drug in the accumulated prescription data. In addition to being able to check in detail, it is also easy to understand intuitively.

It is a block diagram which shows the apparatus structure of a pharmaceutical interaction check apparatus. It is a figure which shows the content of the accumulation prescription data memorize | stored in the memory | storage device of FIG. It is a figure which shows the content of the interaction common master memorize | stored in the memory | storage device of FIG. It is a figure which shows the content of the action master memorize | stored in the memory | storage device of FIG. It is a figure which shows the check result in a new prescription on the screen of "interaction check" displayed on the display apparatus of FIG. It is a figure which shows the check result with an accumulation prescription on the screen of the "interaction check" displayed on the display apparatus of FIG. It is a flowchart which shows the process of the single check operation | movement performed with the central processing unit of FIG. It is a flowchart which shows the process of a patient prescription check performed with the central processing unit of FIG. It is a flowchart which shows the process of the prescription check performed with the central processing unit of FIG. It is a flowchart which shows the process of the multiple partner pharmaceutical check performed with the central processing unit of FIG. It is a flowchart which shows the process of the check between medicines performed with the central processing unit of FIG. It is a flowchart which shows the process of the check screen performed with the central processing unit of FIG. It is a flowchart which shows the process of the check screen performed with the central processing unit of FIG. It is a flowchart which shows the process of the interlocking check operation | movement performed with the central processing unit of FIG. It is a figure which shows the screen of the "prescription check interlocking | linkage" displayed on the display apparatus of FIG. It is a figure which shows the interaction check result printed with the printing apparatus of FIG.

Embodiments according to the present invention will be described below with reference to the accompanying drawings.
FIG. 1 shows a drug interaction check device according to this embodiment. This apparatus includes a display device 1 such as a liquid crystal display, an input device 2 such as a keyboard / mouse, and a storage device 3 such as a hard disk. The entire drug interaction check apparatus is program-controlled by a central processing unit (CPU) 4. Further, a printing apparatus 5 such as a laser printer and a host computer (prescription data transmission apparatus) 6 are connected as necessary. These devices may be constituted by a personal computer. However, the type and number of hardware devices are arbitrary.

  The host computer 6 has a function of transmitting prescription data, and is connected in the case of an interlock check operation (described later). Here, the host computer 6 includes a hospital host in which a hospital prescription ordering system or the like operates, a medical office (receipt) computer of a dispensing pharmacy, or a pharmacy dispensing system control device (built-in computer).

  The central processing unit (CPU) 4 has a built-in memory (RAM) for temporarily storing data necessary for processing. This memory is used as a prescription data memory for storing prescription data and other memories (work data on processing, variables, etc.).

  The storage device 3 stores various data as files and databases. Various types of data include accumulated prescription data that accumulates and stores past prescription data, interaction common master that registers and stores medicinal efficacy combinations and actions, and mutual that registers and stores interactions for each medical facility Stores related information such as individual action master, interaction exclusion master that registers and stores medicinal effects combinations that exclude interaction check, action master that registers and stores action / mechanism details, and prescription data input There are various masters. The various masters include a medicine master, a patient master, a medical department master, a doctor master, a ward master, a prescription category master, a usage master, and the like. The figure is omitted because it is a simple master that stores codes and names.

  The storage device 3 is an independent database server device (CPU built-in), and the central processing unit (CPU) 4, the display device 1 and the input device 2 are connected as client terminals to the server device via a network (LAN). Such a client-server configuration may be used. Further, the server device may be installed in the data center, and the user may execute the application from the browser software of the client terminal via the Internet. Further, the drug interaction check apparatus may share the hardware device with the host computer 6.

  Accumulated prescription data is data that accumulates and stores all prescription data of a patient. The stored contents are shown in FIG. The stored prescription data (FIG. 2) is written by inputting new prescription data by keyboard input in the case of a single check operation (step S66 in FIG. 13). If there is no interaction, it is automatically written (step S78 in FIG. 14) (if there is an interaction, it is written at the operator's discretion as in the single check operation). In the example of “3/10 internal medicine” prescription in FIG. 2, the medical institution code is empty with no data because it is a hospital pharmacy (if a dispensing pharmacy accepts out-of-hospital prescriptions issued by many medical institutions, its identification Because it is an outpatient prescription, the ward code and room number are empty. The drug code (for example, 4490008F1020) uses the 12-digit drug price listed drug code defined by the Ministry of Health and Welfare, but may be a unique code. However, in this case, it is necessary to register the medicinal effect code in the medicinal product master and obtain the medicinal effect code from the medicinal product code. When searching for stored prescriptions, the patient number and medication period are used as search keys.

  Data on combinations of drugs that cause interaction is expressed not by drug codes but by combinations of drug codes in order to reduce the amount of data. These data include a common master that is created from package insert data and distributed to medical facilities, an individual master that each medical facility individually registers an interaction, and an exclusion master that each medical facility excludes an interaction check. is there. These three types of masters have the same data structure, and FIG. 3 shows the storage contents of the interaction common master. In FIG. 3, the main medicinal effect code means a medicinal effect code which is the main combination. The medicinal effect code may be any of the first seven digits of the drug code for inclusion in the drug price standard set by the Ministry of Health and Welfare. The subordinate medicinal effect code means a medicinal effect code that is a subordinate of the combination. The risk level means the risk level of drug interaction. Enter 1 for precautions for combined use and 2 for contraindications for combined use. The action code means an action code of the action master (FIG. 4). In addition, the data of these interaction masters (FIG. 3) is the same as the data of the interaction common / individual / exclusion master registration (same as the data structure) that is activated from the menu screen (not shown because the activation buttons are just arranged). The screen configuration is omitted).

  The action master is data for storing detailed information such as action and mechanism. The stored contents are shown in FIG. Similar to the interaction common master (FIG. 3), the action master is created from the attached document data and distributed to the medical facility, but can be individually registered at each medical facility. The data of the action master (FIG. 4) can be input on the action master registration screen (not shown since it has the same screen structure as the data structure) that is activated from the menu screen (not shown because it is a screen only with start buttons). In FIG. 4, the action code means a unique code for specifying detailed information of action. The action / mechanism content means all detailed information such as action, treatment, bibliographical items, and the like.

  Next, the processing of the single check operation will be described with reference to the flowchart of FIG. Here, the process of the single check operation means a process when the drug interaction check device and the host computer 6 are not connected.

  In this process, first, the menu screen (not shown because it is a screen where only the activation buttons are arranged) is started, and “interaction check” shown in FIG. 5 (check result in new prescription) or FIG. 6 (check result in stored prescription). A screen is displayed (step S1). In this state, today's date is displayed in the “target date” field, and the “patient number” field and the “new prescription” field are empty. Therefore, the patient number and the new prescription drug are input with a keyboard or a mouse (step S2). When input is made in the “patient number” field, a sub-window (not shown) having the same screen configuration as the data configuration shown in FIG. 2 is displayed, and details of the prescription data are input as new prescription data. Then, a “patient prescription check” procedure (FIG. 8) is called to execute a patient prescription check process for performing an interaction check in the new prescription and an interaction check between the new prescription and the stored prescription (step S3). However, it is also possible to execute an interaction check by inputting an arbitrary date in the “target date” column of the check and specifying the target date. Subsequently, the “check screen processing” procedure (FIG. 12) is called, and the check screen processing is executed by a screen operation on the “interaction check” screen (FIG. 5) (step S4). This process is repeated until the “end” button on the “interaction check” screen (FIG. 5) is clicked with the mouse (step S5).

  In the check screen process of step S4, as shown in the flowchart of FIG. 8, first, a new prescription is set in the “self-prescription” of the work data (step S11). Also, a new prescription is set in the “partner prescription” of the work data (step S12). Then, the “check between prescriptions” procedure (FIG. 9) is called to execute an interaction check between self-prescription and partner prescription (check between prescriptions) (step S13). Further, the stored prescription of the same patient is searched from the stored prescription data (FIG. 2) (step S14). Thereafter, it is determined whether or not the accumulated prescription data has been completed (step S15). If completed, the process returns to the single check operation process of FIG. The next stored prescription data is set in (Step S16), and the process is repeated from the inter-prescription check in Step S13.

  In the inter-prescription check process in step S13, as shown in the flowchart of FIG. 9, the first line of the self-prescription (line # 1) is set in the “self drug” of the work data (step S21). Subsequently, a “multiple partner drug check” procedure (FIG. 10) is called, and an interaction check (multiple partner medical product check) between the self drug and the partner prescription drug is executed (step S22). Here, it is determined whether or not all the medicines in the self-prescription have been checked (step S23). If all have been finished, the process returns to the patient prescription check process of FIG. The drug of the next line of the self-prescription is set in the “self-medicine” of the data (step S24), and the process returns to step S22 and the above process is repeated.

  In the multiple partner drug check process of step S22, as shown in the flowchart of FIG. 10, the first column (column # 1) drug of the partner prescription is set in the “partner drug” of the work data (step S31). Then, the “check between medicines” procedure (FIG. 11) is called, and the interaction check between the self medicine and the partner medicine (check between medicines) is executed (step S32). Here, it is determined whether or not all the medicines in the partner prescription have been completed (step S33), and if all have been completed, the process returns to the inter-prescription check in FIG. In the “partner medicine”, the medicine in the next column of the partner prescription is set (step S34), and the process returns to step S32 and the above process is repeated.

  As shown in the flowchart of FIG. 11, the inter-drug check process in step S32 determines whether or not the self-drug and the partner drug are the same (step S41). Return to processing. If they are not the same, for each combination of the medicinal efficacy code of the self-pharmaceutical and the partner drug, there are two master-slave relationships of “self-partner” and “partner-self” (data structure is the same as in FIG. 3). And the corresponding row data is acquired (step S42). Then, an interaction exclusion master (data structure is the same as in FIG. 3) is searched for the combination of the medicinal effect code of the self-medicine and the partner drug, and the corresponding row data is excluded (step S43). Here, it is determined whether or not there is any remaining interaction data excluded from the acquired one (step S44). If there is, interaction data (check result) to be processed by the check screen process (FIG. 12). Is set (step S48). On the other hand, if there is no remaining interaction data, an interaction common master (Fig. 3) is created for the combination of the medicinal efficacy code of the self-medicine and the partner drug with two master-slave relationships of "self-partner" and "partner-self". Retrieval is performed to obtain the corresponding row data (step S45). Then, an interaction exclusion master (data structure is the same as in FIG. 3) is searched for the combination of the medicinal efficacy code of the self-medicine and the partner drug, and the corresponding row data is excluded (step S46). Here, it is determined again whether or not there is any remaining interaction data excluded from the acquired data (step S47). If there is, the check result is set in step S48. Return to the medical check process.

  Further, the check screen process in step S4 of FIG. 7 starts with the check result of the new prescription on the drug matrix display part in the “interaction check” screen (FIG. 5), as shown in the flowcharts of FIGS. Is displayed (step S51). Specifically, it is expressed by a symbol displayed in the “cell” of the matrix, the “Δ” mark is a caution in combination, and the “×” mark is contraindicated in combination. When the “cell” marked with “Δ” or “×” is clicked with the mouse, it is possible to display detailed information such as the action and mechanism in the action display column. In the example of FIG. 5, detailed information is displayed by clicking the “cell” of the “x” mark of the Halcyon tablet and the Itorizol capsule with the mouse. Subsequently, when the “Add medicine” button is clicked with the mouse (step S52), a new medicine is input to the next line of the new prescription by the keyboard and mouse (step S53). Next, an additional medicine is set in the “self medicine” of the work data (step S54). Further, the “multiple partner drug check” procedure (FIG. 10) is called, and an interaction check (multiple partner drug check process) between the additional drug and the multiple prescription drug is executed (step S55). Then, it returns to said step S52 and repeats from medicine addition button judgment. When “tab” (“new prescription” “3/10 internal medicine” in FIG. 5) is clicked with the mouse (step S56), the display is switched to a matrix display in which the partner prescription corresponding to “tab” is a column item (step S57). ), It is determined whether or not there is an additional medicine in the new prescription (step S58), and if there is, the steps S54 and S55 are executed. In the example of FIG. 5, “tab” of “3/10 internal medicine” is clicked with the mouse to switch to the display of FIG. If “cell” is clicked with the mouse (step S61), the action / mechanism content corresponding to “cell” is acquired from the action master (FIG. 4) and displayed on the action display section (step S62). If the check box (□) in the action display section is checked with the mouse (step S63), the data checked with the “∨” mark in the check box becomes the interaction exclusion master (data structure is the same as in FIG. 3). Register (step S64). This is done in order to prevent the adverse effects of excessive use of the combination by excluding drugs with a large number and low importance from the interaction check. If the “registration registration” button is clicked with the mouse (step S67), the prescription data of the new prescription is registered in the accumulated prescription data (FIG. 2) (step S66). If the “print” button is clicked with the mouse (step S65), the contents of the “interaction check” screen (FIG. 5) are printed by the printing device 5 (step S68). And after each said operation is performed, it returns to the said step S52 and repeats from medicine addition button judgment. If the “prescription deletion” and “end” buttons are clicked with the mouse (step S69), the single check operation of FIG. 7 is restored.

  Next, the interlock check operation process will be described with reference to the flowchart of FIG. Here, the process of the interlock check operation means a process when the drug interaction check device and the host computer 6 are connected. Accordingly, new prescription data can be received from the host computer 6 at any time in the drug interaction check device, and the prescription data can be effectively used for checking the interaction.

  The interlock check operation process is started from the menu screen (not shown because it is a screen with only start buttons arranged), and the “prescription check interlock” screen (FIG. 15) is displayed (step S71). If the screen of FIG. 15 is already displayed, it is made an active window. And the prescription data of a new prescription is received from the host computer 6 (step S72). Here, the “patient prescription check” procedure (FIG. 8) is called, and a patient prescription check process including an interaction check in the new prescription and an interaction check between the new prescription and the stored prescription is executed (step S73). The patient prescription check process is the same as the contents described in FIGS. In the display of the result of the interaction check, the problematic date is displayed in the “Target Date” column of the screen, and the check result in the new prescription with the row item and the column item as the new prescription drug is displayed in a matrix format. As shown in FIG. 5, it is displayed with a “tab”. The relationship with the accumulated prescription data having a problem is hidden in another “tab” matrix display, and when the “tab” is clicked with the mouse, the matrix display is switched as shown in FIG.

  Subsequently, one line of prescription data consisting of items from “No.” to “doctor name” in FIG. 15 is displayed (step S74), and it is determined whether or not there is interaction data for contraindications (step S75). . If there is combination contraindication interaction data, a sound generator built in the central processing unit (CPU) sounds a sound to notify the pharmacist (step S76), and a check result (FIG. 16) only for the combined contraindication is printed (step 16). Step S77). If there is no combined contraindication interaction data, normal new prescription data is registered in the accumulated prescription data (FIG. 2) (step S78). Next, it is determined whether or not the “interaction” button has been clicked with the mouse (step S79). If the “interaction” button is clicked with the mouse, the prescription data line selected in reverse display is set as a new prescription, and the “interaction check” screen (FIG. 5) is displayed in a separate window (step S80). Then, after calling the “check screen processing” procedure (FIGS. 12 and 13) and executing the screen operation (check screen processing) on the “interaction check” screen (FIG. 5) (step S81), the process proceeds to step S71. Return and repeat from the “Prescription Check Link” screen display. If the “interaction” button is not clicked with the mouse, it is determined whether or not the “end” button is clicked with the mouse (step S82), and if clicked, the interlock check operation processing is terminated and the menu screen ( If not clicked, the process returns to step S72 and repeats from the reception of new prescription data.

  The interaction check result of the interlock check operation obtained as described above can be printed with the contents shown in FIG. 16, for example. Here, prescription data is received from the host computer 6, an interaction check is executed, and printing is performed only when there are contraindications for combined use. Of course, if the printing amount may be large, a combination warning may be printed.

  In the above-described embodiment, the interaction of medicines can be checked between new prescription data and between new prescription data and stored prescription data, but it is of course possible to recheck between stored prescription data. .

DESCRIPTION OF SYMBOLS 1 ... Display apparatus 2 ... Input device 3 ... Memory | storage device 4 ... Central processing unit (CPU: Control means)
5 ... Printing device 6 ... Host computer

Claims (9)

To any device connected to the network,
Mutually storing combinations in which interactions occur in two types of master-slave relationships: the case of one other medicine seen from one medicine and the one medicine seen from the other one medicine Storage means for storing an action master;
Each drug in the new prescription data entered is self-drug and partner drug, and it is determined whether or not the combination of self-drug and partner drug matches the drug combination registered in the interaction master. Control means for executing the check process;
The result of the interaction check process by the control means displays the name of the target self-medication and the name of the partner drug to be the target of the interaction check process in a matrix-type row or column, respectively. Display means for displaying the result of the interaction check process between the medicines in each corresponding cell of the matrix format;
A drug interaction check system characterized by comprising:   The drug interaction check system according to claim 1, wherein the interaction master stored in the storage unit stores a combination in which an interaction is generated as a combination of drug efficacy codes that define the efficacy of each drug. The storage means further stores an action master in which detailed information including an action / mechanism is associated with each combination of pharmaceuticals in which an interaction occurs.
When each cell in which the result of the interaction check process is displayed is designated, the control unit causes the display unit to display detailed information about the interaction based on the action master stored in the storage unit. The pharmaceutical interaction check system according to claim 1 or 2, wherein The storage means further stores accumulated prescription data obtained by accumulating past prescription data including patient data,
The drug interaction check system according to any one of claims 1 to 3, wherein the partner drug includes each drug of accumulated prescription data.   The display means displays the name of the self-medication and the name of the partner drug in a matrix row or column, respectively, when the partner drug is each drug of the new prescription data, and when the partner drug is each drug of the accumulated prescription data. The pharmaceutical interaction check system according to any one of claims 1 to 4, wherein the drug interaction display system is displayed so as to be switchable between certain cases.   6. The interaction check displayed in each cell of the matrix format displayed on the display means includes a combination caution and a contraindication displayed as identifiable symbols. The pharmaceutical interaction check system according to any one of the above. The display means includes a drug addition button that allows a new medicine to be additionally displayed in addition to each medicine of the new prescription data in the matrix format screen to be displayed.
The control means, when the medicine addition button is operated, in the matrix format screen displayed on the display means, in the row or column where the name of each medicine of the new prescription data is displayed, the name of the new medicine The drug interaction check system according to any one of claims 1 to 6, wherein the interaction between the self-medicine additionally displayed and the partner drug is rechecked. The storage means stores an interaction exclusion master that stores a combination of medicines that excludes an interaction check process among combinations of medicines that generate an interaction registered in the interaction master,
7. The control unit according to claim 1, wherein after executing an interaction check process based on the interaction master, the control unit searches the interaction exclusion master and excludes a combination of the corresponding medicines. The pharmaceutical interaction check system according to claim 1. The storage means stores an interaction individual master created according to each medical facility separately from an interaction common master that stores data on a combination of medicines in which an interaction occurs.
9. The drug interaction according to any one of claims 1 to 8, wherein the control means executes an interaction check process based on the interaction individual master in preference to the interaction common master. Check system.

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