Aurélien Lambert, Benoit Hombourger, Julia Salleron, Fadila Chergui, Catherine Vallance, Nadège Nicolas, Marie Moussouni, Lounisse Cherif, Emile Chenot, Céline Gavoille, Vincent Massard
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引用次数: 0
Abstract
Background: The transition from traditional handwritten prescriptions to electronic prescribing systems represents a significant advancement, with the potential to enhance treatment efficacy, patient safety, and professional communication.
Objective: This study aimed to examine the impact of this transition within a medical oncology service, assessing the compliance of electronic prescriptions with established good practice standards and exploring the associated risks.
Methods: In this retrospective analysis, we compared handwritten prescriptions from the pre-electronic era (January to May 2018) with electronic prescriptions (January to May 2021) following the implementation of the electronic prescribing system PandaLab Pro (PandaLab SAS). The inclusion criteria focused on outpatient oncology treatments, with a clear set of exclusion parameters to ensure a focused study scope. We defined good compliance as the written mention of the evaluated terms. The compliance rates were then compared using a chi-square test.
Results: Our findings, based on a sample size of 260 prescriptions (randomized among 30,526 archived prescriptions), indicate a substantial improvement in electronic prescriptions' compliance with prescribers and patient details, treatment accuracy, and overall adherence to regulatory standards. Notably, electronic formats achieved a remarkable 80.8% accuracy rate in compliance with safety criteria compared with 8.5% for handwritten prescriptions (P<.001). The use of prefilled prescriptions significantly increased compliance from a safety perspective (56% vs 96.2%; P<.001) compared with electronic prescriptions from scratch.
Conclusions: The analysis further underscores the advantages of prefilled electronic prescription templates, which significantly improved compliance rates compared with manually filled electronic and handwritten prescriptions. Furthermore, the study revealed a marked shift in prescribing behaviors, with electronic prescriptions tending to be more concise yet more numerous, suggesting an impact on medication management and patient adherence, which warrants further investigation. The study supports the transition to electronic prescribing systems in oncology, highlighting enhanced traceability, compliance with health authority standards, and patient safety. The implementation of prefilled templates supported by pharmacists has emerged as a pivotal factor in this improved process. While acknowledging certain limitations, such as the nonquantitative assessment of time savings and acceptability, this research advocates for the widespread adoption of electronic prescriptions and serves as a benchmark for future e-prescription initiatives in France.
背景:从传统手写处方到电子处方系统的转变代表了一项重大进步,具有增强治疗疗效、患者安全和专业沟通的潜力。目的:本研究旨在研究这种转变对肿瘤医疗服务的影响,评估电子处方与既定良好实践标准的合规性,并探讨相关风险。方法:通过回顾性分析,将电子处方系统PandaLab Pro (PandaLab SAS)实施后的手写处方(2018年1月至5月)与电子处方(2021年1月至5月)进行比较。纳入标准侧重于门诊肿瘤治疗,具有明确的排除参数,以确保集中的研究范围。我们将良好的遵从性定义为书面提及评估条款。然后用卡方检验比较依从率。结果:我们的研究结果基于260张处方的样本量(从30,526张存档处方中随机抽取),表明电子处方对处方者和患者细节的依从性、治疗准确性和对监管标准的总体依从性有了实质性的改善。值得注意的是,电子格式处方的安全标准符合率为80.8%,而手写处方的符合率为8.5%。结论:该分析进一步强调了预填电子处方模板的优势,与手动填写电子处方和手写处方相比,电子处方模板的符合率显著提高。此外,该研究还揭示了处方行为的显著变化,电子处方趋向于更简洁,但数量更多,这表明对药物管理和患者依从性的影响,值得进一步研究。该研究支持肿瘤学向电子处方系统的过渡,强调了增强的可追溯性、符合卫生当局标准和患者安全。药剂师支持的预填充模板的实施已成为这一改进过程中的关键因素。虽然承认某些局限性,例如对节省时间和可接受性的非定量评估,但本研究主张广泛采用电子处方,并为法国未来的电子处方举措提供基准。
期刊介绍:
The Journal of Medical Internet Research (JMIR) is a highly respected publication in the field of health informatics and health services. With a founding date in 1999, JMIR has been a pioneer in the field for over two decades.
As a leader in the industry, the journal focuses on digital health, data science, health informatics, and emerging technologies for health, medicine, and biomedical research. It is recognized as a top publication in these disciplines, ranking in the first quartile (Q1) by Impact Factor.
Notably, JMIR holds the prestigious position of being ranked #1 on Google Scholar within the "Medical Informatics" discipline.