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篇名
透過資訊系統提升心導管術後抗血小板藥開立率
並列篇名
Enhancing Antiplatelet Prescription Rates post Percutaneous Coronary Intervention via a Medication Reminder System
作者 陳怡儒王詩涵 (Emma Wang)鄭文韋沈玫秋尤士豪吳韋璁
中文摘要
冠心病心導管術前會暫時停用抗血小板藥,出院前若因疏忽忘記加回,病人有極高風險會造成支架栓塞,本研究希望藉由資訊提醒,降低醫師心導管術後疏忽開立抗血小板藥物的情形,進一步減少非預期支架栓塞事件風險。針對冠心病進行心導管介入後忘記開立P2Yl2抑制劑,歸納出四個可能原因:(1)開立出院帶藥時無提醒機制;(2)住院醫師開藥(每個月換單位),不熟悉抗血小板藥物使用;(3)無定期檢討會議,心內醫師不清楚忽略用藥情形;(4)病歷未註明未用藥理由,藥師無法及時把關。擬定兩項對策群組,包括建置冠心病心導管術後用藥提示系統,以及建立團隊定期檢討會議,希望提升出院帶藥開立P2Yl2抑制劑比例達100%。建置冠心病心導管術後用藥提示系統,並定期與醫療團隊開檢討會議後,出院帶藥開立P2Yl2抑制劑比例由97.4%提升至100%,且使用端滿意度良好。透過用藥提示系統與定期檢討會議,可以有效提升抗血小板藥物腮立率。
英文摘要
Patients undergoing percutaneous coronary intervention (PCI) face a temporary cessation of antiplatelet medication, and oversight in reinstating this therapy upon discharge poses a substantial risk of stent thrombosis. This study aimed to mitigate physician negligence in prescribing antiplatelet medication post-PCI through information reminders, thereby reducing the risk of unforeseen stent thrombosis incidents.
For patients with coronary artery disease who forgot to prescribe P2Y12 inhibitors post-percutaneous coronary intervention, four potential reasons were identified: (1) absence of reminder mechanisms during medication prescription at discharge, (2) rotating inpatient physicians unfamiliar with antiplatelet medications due to monthly unit changes, (3) lack of regular review meetings leading to cardiologists' unawareness of medication oversights, and (4) absence of reasons for medication non-prescription in medical records, hindering timely pharmacist oversight. Two strategic intervention groups were devised, involving the establishment of a post-percutaneous coronary intervention medication reminder system and the facilitation of regular team review meetings, aimed at achieving a 100% prescription rate of P2Y12 inhibitors at discharge.
Following the implementation of a post-percutaneous coronary intervention medication reminder system and regular review meetings with the medical team, the prescription rate of P2Y12 inhibitors at discharge escalated from 97.4% to 100%. Moreover, there was a high level of user satisfaction with the system.
The incorporation of a medication reminder system coupled with periodic review meetings proves to be an effective strategy in augmenting the prescription rates of antiplatelet medications post-percutaneous coronary intervention.
起訖頁 19-26
關鍵詞 品管心導管抗血小板藥物P2Y12抑制劑用藥提示系統Quality controlPercutaneous coronary interventionAntiplateletP2Y12 receptor antagonistMedication reminder system
刊名 醫療資訊雜誌  
期數 202403 (33:1期)
出版單位 臺灣醫學資訊學會
該期刊-上一篇 資訊管控系統對管制藥品Painkyl處方開立之影響評估
該期刊-下一篇 應用網頁資訊模組繪製台灣地圖呈現地區健康指標差異
 

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