AutoPharmacist: Automated Medication Monitoring System in Primary Care

**背景**每年超过**40%的英国人服用7.7亿常规药物**来控制和预防疾病。他们的全科医生（GP）肩负着确保他们服用正确药物的艰巨任务，** 15%的人定期服用5种以上的药物，25%的人患有多种长期疾病。****问题**在过度紧张的卫生系统中，药物可能…\***过度使用**：由于副作用、相互作用或无效，在不必要的、可能有害的药物*** ***应** **停止使用*** **使用不足**：在至关重要的、预防疾病的药物*** ***应** **开始使用**两者对国民保健制度的健康后果和成本影响都是完全可以避免的。**目前的做法**医生/药剂师应该……浏览大量的医疗数据，信息“隐藏”在免费文本注释中。从患者那里收集更多信息。保持对每种药物和疾病不断变化的临床指南的最新知识。确定潜在的副作用和禁忌症。当治疗无效时升级治疗**需要**对所有患者进行定期检查，将现有的、明确的指导方针付诸实践，以确定这些错误，并对每个患者进行持续的、临床的、个性化的决定**。改善护理的潜在好处是巨大的，据估计，英国全国医疗服务体系每年可获得25亿英镑的收入。**NHS缺乏能力**安全地做到这一点，原因是：\* COVID-19加剧了严重的人员短缺问题\*要求全年定期为每个人重复整个过程，针对健康数据的每次变化，快速捕获任何安全问题**解决方案**这**_“自动药剂师”_**将根据最新的临床指南持续自动提取和合理化多个数据源，包括现有的患者电子病历记录。组织自动患者问卷，标记潜在的不良副作用，并在需要时进行进一步测试。这一解决办法提供了一个**机会，既能高效、有效地**提供人口健康，又能减少与药物有关的危害。

**BACKGROUND**Every year over **40% of the UK population take 770 million regular medications** to manage and prevent disease. Their General Practitioner (GP) has the vast task of ensuring they are on the right medications, **with 15% of the population taking more than 5 medications regularly, and 25% having multiple long-term conditions.****PROBLEM**In an over-stretched health system, medications can be...\***Overused**: where unnecessary, potentially harmful medicines **should be** **stopped** because of side effects, interactions or ineffectiveness\***Underused**: where vital, disease-preventing medicines **should be** **started**Both have health consequences and cost implications for the NHS that are entirely avoidable.**CURRENT PRACTICE**Doctors/Pharmacists are expected to ...1. look through large volumes of medical data, with information 'hidden' in the free-text notes2.Collect additional information from patients3.Maintain up-to-date knowledge of ever-changing clinical guidelines for each medicine and disease4.Identify potential side effects and contra-indications5.Escalate therapy when the treatment is not working**NEED**Regular reviews for all patients, putting into practice already existing, clear, guidelines would identify these errors with **continuous, clinical, decisions individualised to each patient**.The **potential benefits of improved care** are enormous, an estimated **£2.5 billion per year to the NHS** across the UK.The **NHS lacks capacity** to do this safely due to:\*Critical staffing shortages exacerbated by COVID-19\*Requirements to repeat the whole process for each person, for every change in health data, regularly throughout the year to capture any safety issues quickly**SOLUTION**This **_"Auto-Pharmacist"_** will continuously, automatically extract and rationalise multiple data sources including existing patient EHR records against up-to-date clinical guidelines, organising automated patient questionnaires, flag potential adverse side effects and further testing where required. This solution is an **opportunity to deliver population health delivered efficiently and effectively** whilst reducing medication-related harms.