Interventions Assessment of Prescription Automatic Screening System in Chinese Hospitals: A Systematic Review
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Interventions Assessment of Prescription Automatic Screening System in Chinese Hospitals: A Systematic Review
Drug Information Journal 46(6) 669-676 ª The Author(s) 2012 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0092861512454417 http://dij.sagepub.com
Chunyan Yang, PhD1, Lianping Yang, MS1, Xiaoxi Xiang, PhD1, Yuqing Tang, MS1, Hongtao Wang, MS1, Nathan Bobai, MS1, and Xinping Zhang, PhD, MD1
Abstract Objectives: To systematically assess the outcomes and effectiveness of Prescription Automatic Screening System (PASS) on rational drug use in China. Methods: All studies that evaluated the effects of PASS in Chinese hospitals were electronically searched. Metaanalysis was used to assess the outcomes of intervention effects. Results: Twelve articles that appraised the interventions related to PASS were identified. All studies used before-after designs. Risk ratio was chosen as the effect size index. Heterogeneity was large (I2 > 50%) in all main analyses. Effect sizes were pooled using random effects. Compared with the control group, the pooled effect sizes were 0.60 (95% CI, 0.52-0.70) for the outcome of the incident of inpatient irrational drug use (n ¼ 5), 0.75 (95% CI, 0.59-0.96) for the outcome of the incident of outpatient patient irrational drug use (n ¼ 2), and 0.29 (95% CI, 0.10-0.86) for the outcome of the incidence of black-light warning orders (n ¼ 6). Conclusions: Interventions related to PASS was associated with the reduction of irrational drug use and medication errors. Keywords prescription automatic screening system, evaluation, rational use of drugs, meta-analysis, China
Introduction Irrational drug use is a very serious problem in China.1 Irrational drug use has been reported to account for 12% to 32% of drug usage in China.1 Among the 6 million disabled persons in China, about a third of them have hearing disabilities, in which 60% to 80% were caused by poisoning through the irrational use of streptomycin, kanamycin, and gentamycin.1 Exploring the potential of digital solutions to enhance the quality and safety of health care is of international interest, and the implementation of eHealth technologies is diffused underway.2 For example, computerized physician order entry (CPOE) systems are widely referred to a variety of computer-based systems that share common features in automating the clinical ordering process to ensure standardized, legible, and complete orders.3 Moreover, CPOE in hospitals was reported able to reduce medication errors, such as adverse drug events, and improve safety during the medication process.4 Since 2002, a computer-based system named Prescription Automatic Screening System (PASS) has been used in many general hospitals in China. PASS is a special software system designed for prescription detection, drug information query,
medication education, and medical record query, and it has serviced pharmacists and prescribers with drug alerts.5 These alerts often include drug interactions, repeated drug use, adverse drug reaction (ADR), in-vitro
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