JP2001282923A - Device for checking drug interaction - Google Patents

Abstract

PROBLEM TO BE SOLVED: To display check results of drug interaction in a practically and easily understandable way. SOLUTION: An interaction master composed of drugs combinations by which interactions are generated and stored prescription data obtained by storing the past prescription data including patient data are stored in a storing means 3. A controlling means 4 checks an interaction with each drug of the stored prescription data accessed from the means 3 on the basis of each drug of new prescription data and patient data included the new prescription data, on the basis of the interaction master stored in the storing means. The check results of interactions performed by the means 4 are displayed on a displaying means 1 in the matrix format of each drug of the new prescription data and each drug of the stored prescription data.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a drug interaction checking device used for prescription auditing and prescription designing in medical facilities such as hospitals and dispensing pharmacies.

[0002]

2. Description of the Related Art Conventionally, in a prescription ordering system operated on a host computer such as a hospital, a doctor instructs a prescription of a medicine to be administered to a patient, and when the prescription data is input, an interaction between the medicines, that is, Checks are made to see if the effects of medicines are offset.

[0003] Japanese Patent Application Laid-Open No. 8-57021 discloses a plurality of medicines with reference to a contraindicated relationship between a medicine component registered in the first information and a medicine component registered in the second information. A method for checking contraindications for checking the interaction of the compounds is described.

[0004] Japanese Patent Application Laid-Open No. 8-315040 discloses that the medicine and the administration period designated this time and the medicine and the administration period ordered in the past for the same patient interact with the efficacy of each drug whose administration period overlaps. There is described a medicine ordering system that determines whether or not there is a combination that generates a warning and outputs a warning.

[0005] Japanese Patent Application Laid-Open No. H10-166760 discloses a chart in which symbols or characters indicating the content of the interaction are used in a plurality of intersecting squares for writing the interaction between substances. .

[0006] Japanese Patent Application Laid-Open No. 11-47238 discloses that a drug code is the first seven digits of a drug code listed in the drug price standard specified by the Ministry of Health and Welfare, and that the interaction is expressed by a combination of drug effects and a check result by an IF-THEN rule. An apparatus for creating a drug interaction rule is described.

[0007] Japanese Patent Application Laid-Open No. 11-195078 includes a plurality of codes, such as a receipt computer processing system master code, a generic name code representing a component, and a drug classification code, as drug data. An apparatus for checking drug interaction that searches a table section and displays comment / mechanism data is described.

[0008]

However, in any of the above, the main focus is on checking the interaction between medicines, and the displayed contents are merely simple, such as "A medicine and B medicine are contraindicated for use together." Absent. Therefore, it is not enough for a pharmacist to analyze the details of prescription data, such as auditing the entire prescription including the past prescription data of the same patient or examining an inconvenient drug substitute. In this case, simply displaying the check contents of the interaction is complicated and difficult to see, and is not practical.

Further, in any of the above-mentioned conventional examples, it is impossible to display the data result of the interaction in a format corresponding to each medical facility. In addition, when the interaction of all drugs is checked, a large number of combinations of cautionary notes occur, and the display is very difficult to see.

In particular, a drug having a problem in the result of the interaction check must be replaced with another drug, but no measures have been taken for that.

Accordingly, an object of the present invention is to provide a drug interaction check device capable of displaying the check result of drug interaction in a practical and easy-to-understand manner.

[0012]

According to the present invention, as a means for solving the above-mentioned problems, a medicine interaction check device is provided by using an interaction master comprising a combination of medicines causing an interaction and a past master including patient data. Storage means for storing accumulated prescription data storing the prescription data of each, and each medicine of the new prescription data, and each medicine of the accumulated prescription data called from the storage means based on the patient data included in the new prescription data. Control means for checking the interaction based on the interaction master stored in the storage means, and a check result of the interaction performed by the control means for each drug in the new prescription data and each drug in the accumulated prescription data. And display means for displaying in a matrix format.

With this configuration, it is possible to display the interaction of each drug of the new prescription data and the stored prescription data so that they can be grasped at a glance.

When there are a plurality of stored prescription data stored in the storage means, if the combination of each drug of each stored prescription data and each drug of new prescription data to be displayed in a matrix format on the display means can be switched, This is preferable in that the screen can be prevented from becoming complicated.

The matrix-format screen displayed on the display means displays the result of the interaction check in each cell as a symbol, and displays detailed information on the interaction by designating each cell. This is preferable in that necessary information can be easily obtained while simplifying the process.

In the matrix format screen displayed on the display means, a new drug can be additionally displayed in addition to each drug of the new prescription data, and the control means can display the newly displayed drug and the accumulated prescription data. It is preferable that the interaction with each drug can be rechecked, since it is possible to flexibly respond to changes in the drug.

[0017] The storage means stores an interaction individual master created for each medical facility based on the interaction master, and the control means preferentially uses the interaction individual master for the interaction check. It is preferable that the setting can be made according to each medical facility.

It is preferable that the combination of medicines can be arbitrarily specified and the check can be excluded from the interaction master stored in the storage means, since only the interactions having high importance can be displayed.

The control means receives the prescription data from the host computer, and associates each medicine of the received prescription data with each medicine of the stored prescription data called from the storage means based on the patient data included in the prescription data. It is preferable that the interaction can be checked because an automatic check can be performed without increasing the work load.

[0020]

Embodiments of the present invention will be described below with reference to the accompanying drawings. FIG. 1 shows a drug interaction checking device according to the present embodiment. This device includes a display device 1 such as a liquid crystal display, an input device 2 such as a keyboard and a mouse, and a storage device 3 such as a hard disk. The drug interaction checking device as a whole is program-controlled by a central processing unit (CPU) 4. If necessary, a printing device 5 such as a laser printer,
And a host computer (prescription data transmitting device) 6. These devices may be constituted by personal computers. However, the type and number of hardware devices are arbitrary.

The host computer 6 has a function of transmitting prescription data, and is connected in the case of an interlock check operation (described later). Here, the host computer 6 includes a hospital host on which a prescription ordering system of a hospital operates, a medical office (reception) computer for a dispensing pharmacy,
Or, a pharmacy dispensing system control device (computer built-in) is included.

The central processing unit (CPU) 4 has a built-in memory (RAM) for temporarily storing data required for processing. This memory is used as a prescription data memory for storing prescription data and other memories (work data for processing, variables, etc.).

The storage device 3 stores various data as a file or a database. Various types of data include accumulated prescription data that accumulates and stores past prescription data, an interaction common master that registers and stores the medicinal combinations and effects of interactions, and an interactive master that registers and stores interactions for each medical facility. Stores relevant information such as individual action masters, interaction exclusion masters that register and store drug combinations that exclude interaction checks, action masters that register and store action / mechanism details, and input prescription data. There are various masters. The various masters include a medicine master, a patient master, a medical department master, a doctor master, a ward master, a prescription classification master, a usage master, and the like. Since the master has a simple configuration for storing codes and names, the illustration is omitted.

The storage device 3 is an independent database server device (built-in CPU), and the central processing unit (CPU) 4, the display device 1, and the input device 2 are client terminals, and are connected to the server device and a network (LAN). Alternatively, a client / server configuration may be used, such as a connection using a client. Alternatively, the server device may be installed in a data center, and the user may execute the application from the browser software of the client terminal via the Internet. Furthermore, the drug interaction checking device may share hardware devices with the host computer 6.

The stored prescription data is data for storing and storing all prescription data of the patient. FIG. 2 shows the stored contents. This stored prescription data (FIG. 2) is entered by entering new prescription data via a keyboard in the case of a single check operation (step S66 in FIG. 13). Is received and if there is no interaction, it is written automatically (step S78 in FIG. 14) (if there is an interaction, it is written by the operator in the same manner as in the single check operation). In the example of the prescription “3/10 Internal Medicine” in FIG. 2, the medical institution code is empty with no data because it is a hospital pharmacy (a dispensing pharmacy accepts out-of-hospital prescriptions issued from many medical institutions, so its identification is Is required.),
Since it is an outpatient prescription, the ward code and room number are empty. Pharmaceutical code (example: 4490008F1020) uses a 12-digit pharmaceutical code listed in the NHI drug price standard set by the Ministry of Health and Welfare.
A unique system code may be used. However, in this case, it is necessary to register a medicinal effect code in the medicine master and obtain a medicinal effect code from the medicine code. When searching for a stored prescription, the patient number and the medication period are used as search keys.

Data on a combination of drugs that cause an interaction are expressed not by a drug code but by a drug effect code combination in order to reduce the amount of data. These data include a common master created from the package data and distributed to medical facilities, an individual master where each medical facility registers interactions individually, and an exclusion master where each medical facility excludes interaction checks. is there. These three types of masters have the same data configuration, and the storage contents of the interaction common master are shown in FIG. In FIG. 3, the main efficacy code means the main efficacy code of the combination. The medicinal effect code may be any of the first seven digits of the medicinal product code listed on the drug price standard set by the Ministry of Health and Welfare. The subordinate effect code means a subordinate effect code of the combination. The risk means the risk of drug interaction. Enter 1 if caution is given in combination and 2 if contraindicated in combination. The action code means the action code of the action master (FIG. 4). Note that the data of the master of these interactions (FIG. 3) is the same as that of the interaction started from the menu screen (not shown because it is a screen where only start buttons are arranged).
This is entered on the screen for individual / excluded master registration (not shown because it is the same as the data structure).

The action master is data for storing detailed information such as action and mechanism. FIG. 4 shows the stored contents.
Like the interaction common master (FIG. 3), the action master is created from the package data and distributed to the medical facilities, but can also be registered individually at each medical facility. The data of the action master (FIG. 4) can be input on a screen for registering the action master (not shown because it has the same data configuration as the data configuration) which is started from a menu screen (a screen in which only activation buttons are arranged). In FIG. 4, the action code means a unique code for specifying detailed information of the action. The action / mechanism content means all detailed information such as action, treatment, bibliographic information, and the like.

Next, the processing of the single check operation will be described.
This will be described with reference to the flowchart of FIG. Here, the process of the single check operation means a process in a case where the drug interaction checking device and the host computer 6 are not connected.

In this process, first, the program is started from a menu screen (not shown because the screen only has start buttons).
The “interaction check” screen shown in FIG. 5 (new prescription check result) or FIG. 6 (accumulated prescription check result) is displayed (step S1). In this state, today's date is displayed in the “target date” column, and the “patient number” column and the “new prescription” column are empty. Then, the patient number and the new prescription drug are input using a keyboard or a mouse (step S2). When an entry is made in the "patient number" column, a sub-window (not shown) having a screen configuration similar to the data configuration shown in FIG. 2 is displayed, and details of the prescription data are input as new prescription data. Then, the "patient prescription check" procedure (FIG. 8) is called, and a patient prescription check process for checking the interaction in the new prescription and the interaction between the new prescription and the stored prescription is executed (step S3). However, it is also possible to input an arbitrary date in the “target date” column of the check, specify the target date, and execute the interaction check. Subsequently, the "check screen processing" procedure (FIG. 12) is called, and the check screen processing is executed by operating the screen on the "interaction check" screen (FIG. 5) (step S).
4). This process is performed on the "Interaction Check" screen (Fig. 5).
Is repeated until the "end" button is clicked with the mouse (step S5).

In the check screen process in step S4, as shown in the flowchart of FIG. 8, first, a new prescription is set in the "self-prescription" of the work data (step S4).
11). Further, a new prescription is set in the “other party prescription” of the work data (step S12). Then, the "prescription check" procedure (FIG. 9) is called, and the interaction check (prescription check) between the self-prescription and the partner prescription is executed (step S13). Further, the stored prescription of the same patient is searched from the stored prescription data (FIG. 2) (step S14). Thereafter, it is determined whether or not the stored prescription data has been completed (step S15). If the storage prescription data has been completed, the process returns to the single check operation process of FIG. 7; The next stored prescription data is set (step S16), and the process is repeated from the prescription check in step S13.

As shown in the flow chart of FIG. 9, the pre-prescription check process in step S13 sets the drug in the first line (line # 1) of the self-prescription in the "self-medicine" of the work data (step S21). ). Subsequently, the “multiple partner drug check” procedure (FIG. 10) is called, and an interaction check (multiple partner medical product check) between the self-medicine and the multiple prescription drug is executed (step S2).
2). Here, it is determined whether or not all the checks of the medicines in the self-prescription have been completed (step S23). If all the checks have been completed, the process returns to the patient prescription check process of FIG. The drug in the next line of the self-prescription is set as the “self-medicine” in the data (step S24), and the process returns to step S22 to repeat the above process.

The process of the multiple drug check in step S22 is performed as shown in the flowchart of FIG.
The first column (column #)
The medicine of 1) is set (step S31). And
The “check between medicines” procedure (FIG. 11) is called, and the interaction check between the self-drug and the counterpart medicine (check between medicines) is executed (step S32). Here, it is determined whether or not all the checks of the medicines in the counterpart prescription have been completed (step S33). If all the checks have been completed, the process returns to the prescription check in FIG. 9; The drug in the next column of the other party's prescription is set as the "other drug" (step S34), and the process returns to step S32 to repeat the above processing.

In the process for checking between medicines in the step S32, as shown in the flowchart of FIG. 11, it is determined whether or not the own medicine and the counterpart medicine are the same (step S4).
1) If they are the same, the process returns to the multiple partner drug check process of FIG. If they are not the same, the “self-
An interaction individual master (data structure is the same as in FIG. 3) is searched for in two types of master-slave relations of "partner" and "partner-self", and the corresponding row data is obtained (step S42). And
An interaction exclusion master (having the same data structure as in FIG. 3) is searched for the combination of the medicinal product code of the self-medicine and the other medicine, and the corresponding line data is excluded (step S4).
3). Here, it is determined whether or not there is any remaining interaction data that has been excluded from the acquired data (step S44). If there is, there is interaction data (check result) to be processed by the check screen process (FIG. 12). (Step S4)
8). On the other hand, if there is no remaining interaction data, the interaction common master (Fig. 3) is used for the combination of the medicinal product code of the self-medicine and the partner drug in two different master-slave relations of "self-partner" and "partner-self" A search is performed to obtain the corresponding line data (step S45). Then, an interaction exclusion master (having the same data structure as in FIG. 3) is searched for the combination of the medicinal product code of the self-medicine and the counterpart medicine, and the corresponding line data is excluded (step S46). Here, it is determined again whether or not there is any remaining interaction data excluded from the acquired data (step S47). If there is, the check result is set in step S48.
It returns to the processing of the multiple partner drug check.

As shown in the flow charts of FIGS. 12 and 13, the check screen processing in step S4 of FIG. 7 first sets a new prescription on the pharmaceutical matrix display section on the "interaction check" screen (FIG. 5). Is displayed (step S51). Specifically, it is expressed by a symbol displayed in a “cell” of the matrix, and a “Δ” mark indicates a combined use caution and a “x” mark indicates a contraindicated use. And
By clicking the "セ ル" mark or "x" mark "cell" with the mouse, it is possible to display detailed information such as action and mechanism in the action display column. In the example of FIG. 5, the detailed information is displayed by clicking the “cell” of the “x” mark of the Halcyon tablet and the Itrisol capsule with the mouse. continue,
If the "add medicine" button is clicked on with a mouse (step S52), a new medicine is input to the next line of the new prescription by keyboard and mouse (step S53). Then
An additional medicine is set in the "self-medicine" of the work data (step S54). Further, the “multiple partner drug check” procedure (FIG. 10) is called, and the interaction check between the additional drug and the multiple drug of the partner prescription (multiple partner drug check processing) is executed (step S55). Thereafter, the process returns to the step S52, and the process is repeated from the judgment of the medicine addition button. "Tab"("Newprescription" in Fig. 5 "3/10
"Internal Medicine") is clicked on with a mouse (step S5).
6) Switch to a matrix display in which the other prescription corresponding to the “tab” is a column item (step S57), and determine whether there is an additional drug in the new prescription (step S5).
8) If there is, execute steps S54 and S55. In the example of FIG. 5, the "tab" of "3/10 Internal Medicine" is clicked on with a mouse to switch to the display of FIG. If the "cell" is clicked on with a mouse (step S61), the action / mechanism content corresponding to the "cell" is obtained from the action master (FIG. 4) and displayed on the action display section (step S62).
If the exclusion check box (□) in the action display section is checked with the mouse (step S63), the data checked with a “∨” mark in the check box is set as the interaction exclusion master (the data configuration is the same as in FIG. 3). Register (step S64). This is performed in order to prevent adverse effects due to excessive use of concomitant use by excluding a large number of insignificant drugs from the targets of the interaction check. If the “prescription registration” button is clicked on with a mouse (step S67), the prescription data of the new prescription is registered in the stored prescription data (FIG. 2) (step S66). If the "print" button is clicked with the mouse (step S6)
5) The content of the "interaction check" screen (FIG. 5) is printed by the printing device 5 (step S68). Then, after each of the above operations is executed, the process returns to the step S52 and repeats from the judgment of the medicine addition button. In addition, "prescription erase"
If the "end" button is clicked on with a mouse (step S69), the operation returns to the single check operation in FIG.

Next, the processing of the interlock check operation will be described.
This will be described with reference to the flowchart of FIG. Here, the processing of the interlocking check operation means the processing when the drug interaction checking device and the host computer 6 are connected. Therefore, the drug interaction check device receives new prescription data from the host computer 6 as needed, and can use the prescription data effectively for checking the interaction.

The process of the interlock check operation is started from a menu screen (not shown because it is a screen in which only start buttons are arranged), and a "prescription check interlock" screen (FIG. 15) is displayed (step S71). If the screen in FIG. 15 has already been displayed, the window is set as the active window. Then, the prescription data of the new prescription is received from the host computer 6 (step S72). Here, the "patient prescription check" procedure (FIG. 8) is called, and a patient prescription check process including an interaction check in the new prescription and an interaction check between the new prescription and the stored prescription is executed (step S73).
It should be noted that the patient prescription check process is performed in the same manner as in FIGS.
The contents are the same as those described in 1. Then, in the display of the results of the interaction check, the medication date with the problem is displayed in the “Target date” column of the screen, and the check results in the new prescription with the row item and column item as the new prescription drug are displayed in a matrix format. Is displayed with "tabs" as shown in FIG. The relationship with the stored prescription data having a problem is hidden by another matrix display with “tabs”. When the “tab” is clicked with the mouse, the matrix display is switched as shown in FIG.

Subsequently, "NO." In FIG.
One line of prescription data consisting of the items up to (step S74) is displayed, and it is determined whether there is interaction data contraindicated for use (step S75). If there is interaction data of contraindications, a sound source device built into the central processing unit (CPU) sounds a sound to notify the pharmacist (step S76), and prints a check result (FIG. 16) for only contraindications (FIG. 16). Step S77). If there is no interaction data for contraindications,
The normal new prescription data is registered in the stored prescription data (FIG. 2) (step S78). Next, it is determined whether the “interaction” button has been clicked with the mouse (step S79). If the "interaction" button is clicked on with a mouse, the "interaction check" screen (FIG. 5) is displayed in a separate window with one prescription data line selected in reverse display as a new prescription (step S80). Then, the “check screen processing” procedure (FIGS. 12 and 13) is called,
After executing the screen operation (check screen processing) on the "interaction check" screen (FIG. 5) (step S81), the process returns to the step S71 and repeats from the "prescription check linked" screen display. If the "interaction" button has not been clicked with the mouse, it is determined whether the "end" button has been clicked with the mouse (step S82). If not clicked, the flow returns to step S72 to repeat from the reception of the new prescription data.

The interaction check result of the interlock check operation obtained as described above can be printed, for example, with the contents shown in FIG. Here, prescription data is received from the host computer 6, an interaction check is performed, and printing is performed only when there is contraindicated use. Of course,
If a large print amount is acceptable, the combined notice may be printed.

In the above-described embodiment, the interaction of medicines can be checked between new prescription data and between new prescription data and stored prescription data. However, it is also possible to check again between stored prescription data. Of course.

[0040]

As is apparent from the above description, according to the present invention, the check result of the interaction is displayed in a matrix format of each drug of the new prescription data and each drug of the accumulated prescription data. Therefore, the interaction can be checked in detail, and it can be intuitively understood.

Further, since the combination of each medicine in each stored prescription data and each medicine in the new prescription data can be switched, a simple display can be achieved with a reduced display area.

Further, detailed information on the interaction can be displayed by designating each cell of the matrix format screen, so that not only can it be grasped at a glance, but also the detailed information can be easily obtained as needed. .

Further, since the interaction between the additionally displayed medicine and each medicine in the accumulated prescription data can be rechecked, it is easy to consider replacing a problematic medicine with another medicine.

Further, since an interaction individual master corresponding to each medical facility can be created, it is possible to make appropriate settings for each medical facility.

Further, since the combination of medicines can be arbitrarily specified and the check can be excluded, only the interactions having high importance can be displayed, and the adverse effect due to excessive information can be prevented.

Further, since the interaction with each medicine can be checked based on the prescription data received from the host computer, the interaction can be automatically checked for all prescriptions to be dispensed without increasing the work load. .

[Brief description of the drawings]

FIG. 1 is a block diagram showing a device configuration of a drug interaction check device.

FIG. 2 is a diagram showing contents of stored prescription data stored in a storage device of FIG. 1;

FIG. 3 is a diagram showing contents of an interaction common master stored in a storage device of FIG. 1;

FIG. 4 is a diagram showing contents of an action master stored in a storage device of FIG. 1;

FIG. 5 is a view showing a check result in a new prescription on a screen of “interaction check” displayed on the display device of FIG. 1;

FIG. 6 is a diagram showing a check result with an accumulated prescription on a screen of “interaction check” displayed on the display device of FIG. 1;

FIG. 7 is a flowchart showing processing of a single check operation performed by the central processing unit of FIG. 1;

FIG. 8 is a flowchart showing a patient prescription check process performed by the central processing unit of FIG. 1;

FIG. 9 is a flowchart showing an inter-prescription check process performed by the central processing unit of FIG. 1;

FIG. 10 is a flowchart showing a process of a multiple partner drug check performed by the central processing unit of FIG. 1;

11 is a flowchart showing a process of checking between medicines performed by the central processing unit of FIG. 1;

FIG. 12 is a flowchart showing a process of a check screen performed by the central processing unit of FIG. 1;

FIG. 13 is a flowchart showing processing of a check screen performed by the central processing unit of FIG. 1;

FIG. 14 is a flowchart showing a process of an interlock check operation performed by the central processing unit of FIG. 1;

FIG. 15 is a diagram showing a “prescription check interlocking” screen displayed on the display device of FIG. 1;

FIG. 16 is a diagram illustrating an interaction check result printed by the printing apparatus of FIG. 1;

[Explanation of symbols]

 REFERENCE SIGNS LIST 1 display device 2 input device 3 storage device 4 central processing unit (CPU: control means) 5 printing device 6 host computer

Claims (7)

[Claims] 1. An interaction master comprising a combination of medicines causing interaction, storage means for storing accumulated prescription data obtained by accumulating past prescription data including patient data, each medicine of new prescription data, Control means for checking the interaction of the stored prescription data called from the storage means with each drug based on the patient data included in the new prescription data, based on the interaction master stored in the storage means; A drug interaction check device, comprising: display means for displaying a check result of an interaction performed by a control means in a matrix format of each drug of new prescription data and each drug of accumulated prescription data. 2. When there are a plurality of stored prescription data stored in said storage means, a combination of each drug of each stored prescription data and each drug of new prescription data to be displayed in a matrix format on said display means can be switched. The drug interaction check device according to claim 1, wherein: 3. The matrix screen displayed on the display means displays the result of the interaction check in each cell as a symbol, and allows detailed information on the interaction to be displayed by designating each cell. Claim 1 characterized by the following:
Or the drug interaction check device according to 2. 4. In the matrix format screen displayed on the display means, a new drug can be additionally displayed in addition to each drug of the new prescription data, and the additionally displayed drug and the stored prescription are controlled by the control means. The drug interaction check device according to any one of claims 1 to 3, wherein the interaction of the data with each drug can be checked again. 5. An interaction individual master created for each medical facility based on the interaction master is stored in the storage unit, and the interaction individual master is given priority by the control unit by the interaction check. The drug interaction checking device according to any one of claims 1 to 4, wherein the drug interaction checking device is usable. 6. The medicine interaction according to claim 1, wherein a combination of medicines can be arbitrarily designated in the interaction master stored in the storage means so that the check can be excluded. Action check device. 7. The control means receives prescription data from a host computer, and each medicine of the received prescription data and each medicine of the stored prescription data called from the storage means based on the patient data included in the prescription data. The drug interaction check device according to any one of claims 1 to 6, wherein an interaction with the drug can be checked.