Poster
# 31
Poster |
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6th Internet World Congress for Biomedical Sciences |
Carmen Portuondo(1), Miriam Cires(2)
(1)(2)Centro para el Desarrollo de la Farmacoepidemiologia - Ciudad Habana. Cuba
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[Hygiene, Public Health & Preventive Medicine] |
[Health Informatics] |
Sometimes the physician has not a variety of sources of information at hand. When in the clinical practice certain groups of patiens ( e.g. pregnant women , children, olderly ) need differents drugs for whom standard treatment may not be optimal, the physicians need information and education on drug prescribing, and therapeutic consultation service can get it.
We describe the development of a computarized therapeutic consultation service and the esperience of the first year in Cuba.
The therapeutic consultation system was development in Microsoft Access, wich has a database with differet fields that store the necessary information about the consultation.
The automated consultation system is isntalled in a PC (Pentium II) located int the National Pharmacoepidemiology Development Center.
The Service was designed to solve clinical questions that can not be answered by consulting desk references.
From the begining one clinical pharmacologist and a paediatrician worked in the service, fulltime. Queries are received by telephone, e-mail, letters, fax or personal comunication. For each enquiry a standard form is filled in including the number, date, name, position, and address of the enquirer, the problem posed, drug involved, text of the answer, advice given, bibliographic sources used, references, the name of the person responsible for the answer, and a number of key words.
After that the specialists give the correct answer, wich is put in a one of the filds of the form. Thereafter all reports are included in a database fromm wich information can be easily retrieved by the same logic. When an enquiry is made the database is consulted seeking a similar previous enquiry, which may be used wholly on in a part to prepare the response.
The database is built in Acces language and includes some dictionaries such as: a dictionary of keywords, names of microorganims which are included in the database, dictionary of generic names, trade marks and therapeutic groups, organized according to the Anatomical and Therapeutic Classification (ATC) of drug and pharmaceutical drug reactions .
Some of the ouputs of the system are:
- Origin of the consultation received (primary health care, hospitals)
- Distribution of the consultation by speciality.
- Distribution of the consultation by topics.
- Distribution of the consultation by patients or group of patients.
- Distribuction of the comnsultation by months and years.
- Search an especific information.
Between January 1998 and December 1999 , 79 enquieres were received. The majority come from primary health care ( 32 ; 40 % ) as we can observed on the table 1
Table 1
Enquires according to the procedent
No. %
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Primary health care 32 40
Hospitals 18 23
Others 29 37
Total 79 100
Table 2 We can observated that 80% of the enquires were get fron psysicians.
No. %
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Physicians 63 80
Pharmacists 11 12
Patients 3 5
Others 2 3
Total 79 100
The prescribers who enquire can not be considered representative of all prescribers.
Table 3. Topics of enquiries
Enquiries*
Topic No. %
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Factual or evaluated documentation 57 72
Adverse reaction 8 10
Choice of drugs or therapeutic strategy 7 9
Interactions 3 4
Drugs in children 3 4
Technology 3 4
Drug in pregnancy 2 3
(*) The number and percentages sum up more than 79 and 100 respectively , because for some enquires more than one topic is recorded.
The topics of enquiries more relevant was factual of evaluated documentation with 72 % , it follows of adverse reaction ( 10 % ) and choice of drugs or therapeutic strategy 9 %
Table 4 Groups of drugs involved in therapeutic consultation
Group Enquiries
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J01 General anti-infectives systemic 12 15
M01 Anti-inflammatory 11 14
N06 Psycoanaleptics 9 11
A11 Vitamines 8 10
C02 Hypotensives 7 9
R03 anti-asthmatics 5 6
C03 Diuretic 3 4
A02 Anti-peptic ulcerants 3 4
H05 Hormonas 3 4
R06 Histamine H1 receptor antagonist 3 4
C01 Anti-anginal 2 3
A10 Hipoglycaemic agent 1 1
P01 Antiparasitics products 1 1
Otros 11 14
The group of drug more asked about were general anti-infectives systemic and anti-inflammatory drugs.
Actually , the specialists introduce the consultations sended by the users of this service using the software designed for that.
The answers can be send by email to the users or for another way.
With this system the search time is optimized .
In that moment we have much of the consultation in the computer. The access to make the search is more efficient than before.
An important proportion of the consultations made come from primary health care of pharmacoepidemiologist .
Therapeutic consultation has significant teaching value for specific aspects of drug therapy and general methodological issues in clinical evaluation of pactiens.
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[Hygiene, Public Health & Preventive Medicine] |
[Health Informatics] |