為避免藥物不良反應的發生，藥師除積極藉由文獻資料之蒐集，提供醫師藥物選用及劑量調整之建議外，藉由醫療資訊系統的建置，除可輔助醫師開方，亦可提供藥師進行監測，進而減少藥品之毒、副作用的產生，達到落實提昇用藥安全之目標。
本研究主要針對某區域教學醫院以醫療資訊平台建立之腎排泄藥物監測系統 進行統計分析。當病人血中肌酐酸值大於 1.5 mg/dL，且併用該系統所建置之32 種會影響或危及腎功能的任一藥品時，電腦介面便會篩選並提示符合上述兩項條件之病患處方。本研究蒐集分析自 2005 年 1 至 6 月住院病患之醫師錯誤處方的件數及分類，對照 2004 年 1 至 6 月系統尚未建置前之相關資料，進行醫師錯誤處方類型 的比較與統計分析。
系統建置前後之統計結果顯示，2004 年及 2005 年住院病患之醫師錯誤處方件 數分別為 175 件及 398 件。其中因腎功能不良，而接受藥師建議調整處方者，分別為 15 件與 174 件，佔所有醫師錯誤處方之 8.5 %及 43.7 %。
肝、腎是藥物代謝的重要器官，經由腎排泄藥物監控系統之提示，藥師可篩選出腎功能不全之病患，進行該病患之藥品使用評估，並提供醫師作為劑量調整，甚或更改藥品使用品項之建議，以提升並確保病患之用藥安全，並降低病患因腎功能不全所造成之不良反應及藥物毒性。
In order to avoid adverse drug reactions, it is believed that the toxicity and adverse effects of drugs can be reduced by establishing a computerized data system to assist clinicians to make prescription and help pharmacists to monitor, in addition to the clinicians’participating in searching relevant literatures for useful data, so as to accomplish the objective of drug safety.
In this study, the Monitoring system of Renal Excretion Drugs is established on a medical data platform, so that the computer interface will indicate and screen out the prescriptions of patients whose serum creatinine is over 1.5 mg/dl, and who is concomitantly being administered with any one of the 32 drugs selected by system that either are eliminated from kidney or affect renal function. The clinicians’ faulty clinicians for the inpatients from January to June in 2005 are selected and compared with relevant data from January to June in 2004 when the system hadn’t been established, so as to make a comparison and statistical analysis of the types of the clinicians’faulty prescriptions.
Since the system was established, the statistical results showed that the total number of faulty prescriptions of inpatients were 175 and 398. In 15 and 174 cases, adjustment was made because of renal dysfunction, accounting for 8.5% and 43.7% of all the clinicians’ faulty prescriptions respectively.
Liver and kidney are the major organs of drug metabolism, the pharmacists are able to screen out the patients with renal dysfunction, based on the renal function drug monitoring system, and thus to evaluate the drugs to be administered in the patients and advise the clinicians to properly adjust the dosage or even alternate the drug, and as a result, to promote and assure drug safety, as well as to minimize adverse drug reaction and toxicity associated with renal dysfunction.
