2019 Volume 43 Pages 17-22
Objectives; We had developed a clinical decision support system, which enabled physicians to order any medication with recommended doses based on the updated renal function of each inpatient at Shimane Prefectural Central Hospital. We launched the same system into outpatient settings, and evaluated them. Methods; We developed the clinical decision support system which automatically recommended appropriate doses for any medication which needed to be adjusted for renal function for inpatients. Recommended doses were displayed on the screen for inpatients, the physician could finally select the clinical dose. Since October 2017, we installed the system in outpatients, but the recommended doses were not displayed on the screen and ran in the background to measure the baseline data. We measured the antimicrobial prescription contents for 10 months until July 2018 to predict the actual effect after system operation. Results; We obtained 35,594 drugs regulated by renal function orders for outpatients during the study period. Patients who ordered 5,675 medications （16％） did not have renal function test which was needed. In addition, 2,067 orders （6％） were incorrect dose （over or under） . Conclusion; The clinical decision support system equipped with recommended antibiotics dose by renal function were useful for outpatients to reduce the inappropriate dose.
