電子カルテ導入後の調剤業務における薬学的介入の検討

Abstract

At Kyoto University Hospital,we introduced an electronic medical recording system in October 2005.We then investigated interventions in the dispensing room as well as the usage of electronic medical records in our satellite-like pharmacy from June through August 2007.The number of prescriptions in this period was 29,618,and we had questions concerning 840 of them,a quarter of which could be answered using electronic medical records.Of the 640 prescriptions that we contacted physicians about,either asking questions or making recommendations,82.5% were changed.On comparing the pharmaceutical interventions in the dispensing room made this time with those made in the course of conducting pharmaceutical care services in our previous report of 2003,when an electronic medical recording system had not be introduced,pharmacists mainly made recommendations to physicians based on standard pharmacotherapy,such as those concerning inappropriate dosages,indications and drug interactions (69%),and pointed out errors in prescriptions (15%).However,pharmaceutical care interventions had also been based on standard therapy in consideration of individual patient backgrounds,such as those concerning dosage adjustment in view of patient renal function,and adverse effects.For dispensing,our findings suggested that though the intervention rate was not very high,hospital pharmacists had been able to conduct interventions based on standard pharmacotherapy covering all types of patient.In addition,ward pharmacists had been able to conduct pharmaceutical care interventions for specific patients based on individual situations.In conclusion,the results of our investigation show that clinical pharmacists in the dispensing room and wards are able to work together in promoting optimal pharmacotherapy which prevents various risks.