1998 Volume 118 Issue 5 Pages 168-178
It has now become possible to perform a computer-aided inspection of prescriptions, due to a recent trend of introducing an order entry system to medical facilities. A checking system of drug interactions at the level of physicians' order entry, although tested in some hospitals, is not yet established as a practical system in the actual situations, due to its delaying effect on the response of the order entry system and thus on the patients' staying time. Therefore, we have devised an on-line method by which a prescription information paper can be printed out with patient's drug history records regarding selected, problem-inducible drugs prescribed over the past five visits of the patient's to any of the wards in our hospital. This method enabled us to construct a prescription-inspecting supporting system, with which pharmacists can rapidly and accurately inspect prescriptions focusing on the drug interactions without any effect on the response of the present order entry system. Subsequently, we evaluated the 5465 outpatient- and 1550 inpatient-prescriptions using the present inspection-supporting system from the viewpoint of proper drug usage. It was found that as much as 17% and 28% of the outpatient- and inpatient-prescriptions, respectively, contained selected problem-inducible drugs, not only from a single department (55%) but also from multiple departments (45%) of our university hospital. Moreover, approximately 11% of the prescriptions which contained problem-inducible drugs (i. e., 1.2% of all the prescriptions) were actually inquired to physicians to avoid possible drug interactions, which was a reasonable frequency of inquiry. Taken all together, the present system was suggested to be a simple but practical method for avoiding adverse drug interactions.
