摘要目的 应用触发器技术构建药物不良反应(ADR)主动监测系统并探讨其应用价值.方法 基于DTHealth系统和电子病历系统,采用Brower/Server架构,应用DHCMedBase 2.0.doc、Ext3.1-API Documentation技术开发设计数据定义语言触发器程序,筛选能够用临床检验数据体现的ADR,与临床相关科室人员沟通后设定12项触发器,将相关程序嵌入医院信息系统,构建ADR主动监测系统.由3名药师专职负责该系统的运行,对全院23个病区约800例患者通过触发器检索进行ADR监测,完成对可疑ADR的筛选、评价和上报. 结果 触发器ADR主动监测系统构建成功后于2014年1月1日启用,运行至同年6月30日,共监测到触发器阳性患者561例,确认ADR 71例,总检出率为12.7％;涉及药物28种;发现21例入院后实验室指标发生明显变化但未超出正常范围者,其中12例患者更改治疗方案以避免可能发生的ADR. 结论 应用触发器技术成功构建了ADR主动监测系统,该系统可明显提高ADR主动监测工作效率,同时实现ADR预警功能.

abstractsObjective To construct the active monitoring system for adverse drug reactions based on the trigger technology and explore its application value.Methods Based on the DTHealth system and electronic medical records system, using the Brower/Server architecture, DHCMedBase2.0.doc, Ext 3.1-API Documentation technology to design the trigger of the data definition language.The monitoring group selected the adverse drug reactions which can be used to reflect with the laboratory information, 12 triggers were chosen after communicating with the clinical medical staff, the related procedures were embedded in the hospital information system, accordingly, the active monitoring system of adverse drug reaction based on the trigger technology were constructed.By the three pharmacists the full-time work, the monitoring work within 23 wards of the hospital about 800 patients were finished through the triggers of adverse drug reactions monitor, and the suspected adverse drug reactions were filtered, evaluated and reported.Results The active monitoring system of adverse drug reactions based on the trigger technology started operation in January 1st, 2014, and run until the June 30th, 2014, 561 positive patients were monitored by the triggers, and 71 adverse drug reactions which involved 28 kinds of drugs were identified, the total positive rate was 12.7％.The laboratory index of 21 patients were found to have a marked abnormality but not beyond the normal range, among them the 12 patients had to change the treatment to avoid the possible adverse drug reactions.Conclusion The application of the trigger technology successfully constructed the active monitoring system of adverse drug reactions, which can improve efficiency of the active monitoring for adverse drug reactions,at the same time, realize the early warning function.