Antiemetic prescribing practices using a computerized physician order entry system.
Antiemetic prescribing practices using a computerized physician order entry system.
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DOI：
10.1007/s00520-013-1969-2
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发表时间：
2014-01
影响因子：
3.1
通讯作者：
Loprinzi, Charles L.
中科院分区：
文献类型：
--
作者：
Kadakia, Kunal C.;Leal, Alexis D.;Seisler, Drew K.;Qin, Rui;Fee-Schroeder, Kelliann C.;Grendahl, Darryl C.;Sorgatz, Kristine M.;Loprinzi, Charles L.
关键词：
坚持指南一致的化疗诱导的恶心和呕吐（CINV）预防是次优的。本研究的主要目的是评价在一家三级医疗机构使用计算机医嘱输入系统对机构指南指导的止吐预防的依从性。还进行了护士调查，以评估如何肿瘤学的做法，在一个合作小组，管理临床医生的订单，预防CINV。对100例连续患者的电子病历进行了评价。主要终点是对急性（第1天）和迟发性（第2-4天）CINV提供计划的机构指南导向的止吐预防的所有方面的依从性发生率。对便利样本进行描述性分析。进行Logistic回归分析，以确定不依从性的预测因素。第1-4天的依从性发生率为94%。一半的非依从性事件（6例中的3例，50%）仅发生在第1天，涉及接受低致吐性化疗的患者。对迟发性CINV治疗的机构指南有很高的依从性（97%）。观察到接受极轻微致吐和中度致吐化疗的患者（N =70）100%依从。与接受其他化疗方案的患者相比，接受多柔比星/环磷酰胺治疗的患者接受机构指南的可能性在数值上更低（OR，0.24（0.04，1.36），p值，0.05）。护士调查表明，在止吐药处方实践方面，相关机构存在显著差异。根据机构指南，对于急性和延迟CINV，计算机化医嘱输入与对临床医生处方实践的令人印象深刻的遵守相关。
Adherence to guideline-consistent chemotherapy-induced nausea and vomiting (CINV) prophylaxis is suboptimal. The primary aim of this study was to evaluate the magnitude of compliance to institutional guideline-directed antiemetic prophylaxis using a computerized physician order entry system at a single tertiary care institution. A nurse survey was also performed to evaluate how oncology practices, within a cooperative group, managed clinician orders for the prevention of CINV. The electronic medical records of 100 consecutive patients were evaluated. The primary endpoint was the incidence of compliance to provide all aspects of scheduled institutional guideline-directed antiemetic prophylaxis for acute (day 1) and delayed (days 2–4) CINV. A descriptive analysis was performed on the convenience sample. Logistic regression was completed to determine the predictors of noncompliance. The incidence of compliance on days 1–4 was 94 %. Half of the noncompliant events (three of six, 50 %) occurred on day 1 alone and involved patients receiving low-emetogenic chemotherapy. There was a high degree of compliance to institutional guidelines for the treatment of delayed CINV (97 %). Patients receiving minimally emetogenic and moderately emetogenic chemotherapy (N =70) were observed to be 100 % compliant. Patients receiving doxorubicin/cyclophosphamide were numerically less likely to receive institutional guidelines, compared to patients receiving other chemotherapy regimens (OR, 0.24 (0.04, 1.36), p value, 0.05). The nurse survey suggested significant variability amongst the involved institutions with regards to antiemetic prescribing practices. Computerized physician order entry is associated with impressive adherence to clinician-prescribing practices, according to institutional guidelines, for acute and delayed CINV.
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影响因子：
--
作者：
Sklarin, Nancy T.;Granovsky, Svetlana;Zelenetz, Andrew D.
通讯作者：
Zelenetz, Andrew D.
影响因子：
3.1
作者：
Dranitsaris, G;Leung, P;Warr, D
通讯作者：
Warr, D
DOI：
10.6004/jnccn.2009.0040
发表时间：
2009-05-01
影响因子：
13.4
作者：
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通讯作者：
Grunberg, Steven M.
影响因子：
45.3
作者：
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通讯作者：
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影响因子：
50.5
作者：
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通讯作者：
Warr, D.