The Effect Object Paradigm - a Means to Support Medication Safety with Clinical Decision Support

被引:3
作者
Patapovas, Andrius [1 ]
Pfistermeister, Barbara [2 ]
Tarkhov, Aleksey [3 ]
Terfloth, Lothar [3 ]
Maas, Renke [2 ]
Fromm, Martin F. [2 ]
Kornhuber, Johannes [4 ]
Prokosch, Hans-Ulrich [1 ]
Buerkle, Thomas [1 ]
机构
[1] Friedrich Alexander Univ Erlangen Nurnberg, Chair Med Informat, Erlangen, Germany
[2] Friedrich Alexander Univ Erlangen Nurnberg, Inst Expt & Clin Pharmacol & Toxicol, Erlangen, Germany
[3] Mol Networks, Erlangen, Germany
[4] Friedrich Alexander Univ Erlangen Nurnberg, Univ Hosp, Dept Psychiat & Psychotherapy, Erlangen, Germany
来源
E-HEALTH - FOR CONTINUITY OF CARE | 2014年 / 205卷
关键词
Clinical Decision Support System; Medication Safety; Summary of Product Characteristics; PRESCRIBING INFORMATION; DRUG; WARNINGS;
D O I
10.3233/978-1-61499-432-9-1065
中图分类号
TP39 [计算机的应用];
学科分类号
081203 ; 0835 ;
摘要
Background: In many countries, officially approved drug information known as summary of product characteristics (SPC) is mostly available in text form, which cannot be used for Clinical Decision Support Systems (CDSS). It may be essential however to substantiate CDSS advice with such legally binding text snippets. In an attempt to link various drug data sources including SPC towards a CDSS to support medication safety in psychiatric patients we arrived at the notion of an effect object. Methods: A requirements analysis revealed data items and data structure which are needed from the patient and from the drug information source for the CDSS functionality. Published drug data modelling approaches were analyzed and found unsuitable. A conceptional database modeling approach using top down and bottom up modeling was performed. Results: The schema based data model implemented within the django framework centered on SPC "effect objects" which comprise all SPC data required for the respective CDSS function such as search for contraindications in the proposed medication. Today six effect objects have been defined for contraindications and warnings, missing indications, adverse effects, drug-drug interactions, dosing and pharmacokinetics. Conclusion: The transformation of SPC data to a database-driven "effect objects" structure permits decoupling between the CDSS functions and different underlying data sources and supports the design of reusable, stable and verified CDSS functions.
引用
收藏
页码:1065 / 1069
页数:5
相关论文
共 16 条
[1]   Prerequisites for electronic systems evaluating safe and effective drug therapy [J].
Aly, A. -F. ;
Menges, K. ;
Haas, C. H. ;
Zimmermann, L. ;
Kaltschmidt, J. ;
Criegee-Rieck, M. .
BUNDESGESUNDHEITSBLATT-GESUNDHEITSFORSCHUNG-GESUNDHEITSSCHUTZ, 2011, 54 (11) :1170-1178
[2]   Coverage of FDA Medication Boxed Warnings in Commonly Used Drug Information Resources [J].
Cheng, Christine M. ;
Guglielmo, B. Joseph ;
Maselli, Judy ;
Auerbach, Andrew D. .
ARCHIVES OF INTERNAL MEDICINE, 2010, 170 (09) :831-833
[3]  
Chute C G, 2003, AMIA Annu Symp Proc, P170
[4]  
CURE O, 2007, ONTOLOGY BASED DATA
[5]  
E.M. Agency, 2010, PIM CONC PIM DES V21
[6]   Facilitating Secondary Use of Medical Data by Using openEHR Archetypes [J].
Kohl, Christian D. ;
Garde, Sebastian ;
Knaup, Petra .
MEDINFO 2010, PTS I AND II, 2010, 160 :1117-1121
[7]   A data model for managing drug therapy within a patient data management system for intensive care units [J].
Michel, A ;
Junger, A ;
Benson, M ;
Brammen, DG ;
Hempelmann, G ;
Dudeck, J ;
Marquardt, K .
COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE, 2003, 70 (01) :71-79
[8]  
NHS, 2013, DICT MED DEV DAT MOD
[9]   Do computerised clinical decision support systems for prescribing change practice? A systematic review of the literature (1990-2007) [J].
Pearson, Sallie-Anne ;
Moxey, Annette ;
Robertson, Jane ;
Hains, Isla ;
Williamson, Margaret ;
Reeve, James ;
Newby, David .
BMC HEALTH SERVICES RESEARCH, 2009, 9
[10]   Different indications, warnings and precautions, and contraindications for the same drugan international comparison of prescribing information for commonly used psychiatric drugs [J].
Pfistermeister, Barbara ;
Schenk, Christian ;
Kornhuber, Johannes ;
Buerkle, Thomas ;
Fromm, Martin F. ;
Maas, Renke .
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, 2013, 22 (03) :329-333