Medication management system and medication management program

Abstract

To provide a medication management system capable of discovering a sign of prescribing cascade, and to provide a medication management program.SOLUTION: A medication management system 10 includes a first determination processing part 112 and a second determination processing part 113. The first determination processing part 112 determines whether or not the combination of two or more medicines which are medication objects of a patient satisfies a first determination condition. The second determination processing part 113 determines whether or not a second determination condition related to two or more medicines is satisfied.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates to a medication management system and a medication management program for managing medication administered by patients. [Background technology]

[0002] As a related technique, a medication management system (ward pharmaceutical work support system) is known that can automatically determine the necessity of inspection of prescription data by a ward pharmacist and automatically assign and have the ward pharmacist carry out the inspection work (see, for example, Patent Document 1). The medication management system includes an inspection determination processing unit that determines whether or not inspection by the ward pharmacist working in the ward where the patient is hospitalized is necessary based on the prescription data and predetermined ward inspection conditions, and an issuance control processing unit that issues the prescription data that has been determined by the inspection determination processing unit to require inspection by the ward pharmacist as a prescription to be dispensed when an issuance operation is performed by the ward pharmacist.

[0003] For example, the ward inspection condition is that one or a combination of the following is satisfied: the prescription category of the prescription data is a predetermined category, the ward of the patient corresponding to the prescription data is a predetermined ward, the medical department of the patient corresponding to the prescription data is a predetermined medical department, the patient corresponding to the prescription data is a predetermined patient, the disease of the patient corresponding to the prescription data is a predetermined disease, and the prescription data includes a predetermined drug. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] JP 2016-45926 A Summary of the Invention [Problem to be solved by the invention]

[0005] Incidentally, one of the causes of polypharmacy is a "prescription cascade," which is a chain of prescriptions that occurs when adverse events caused by medication are mistaken for new symptoms. In the medication management system according to the related art, even if it is determined that an inspection by the ward pharmacist is necessary, it is difficult to find signs of the prescription cascade, depending on the proficiency of the ward pharmacist.

[0006] An object of the present invention is to provide a medication management system and a medication management program that can detect signs of prescription cascade. [Means for solving the problem]

[0007] A medication management system according to one aspect of the present invention includes a first determination processor and a second determination processor. The first determination processor determines whether a combination of two or more drugs to be taken by a patient satisfies a first determination condition. The second determination processor determines whether a combination of two or more drugs satisfies a second determination condition related to the two or more drugs.

[0008] A medication management system according to another aspect of the present invention extracts combinations of two or more drugs suspected of prescription cascades from among a plurality of drugs to be taken by one patient.

[0009] A medication management program according to another aspect of the present invention is a program for causing one or more processors to execute a first determination step and a second determination step. In the first determination step, it is determined whether or not a combination of two or more drugs to be taken by a patient satisfies a first determination condition. In the second determination step, it is determined whether or not a second determination condition related to the two or more drugs is satisfied. Effect of the Invention

[0010] According to the present invention, a medication management system and a medication management program are provided that are capable of detecting signs of prescription cascade. [Brief description of the drawings]

[0011] [Figure 1] FIG. 1 is a block diagram showing the configuration of a medication management system according to an embodiment of the present invention. [Diagram 2] FIG. 2 is a schematic diagram showing an example of a prescription cascade to be checked by the medication management system according to an embodiment of the present invention. [Diagram 3] FIG. 3 is a diagram showing an example of a prescription cascade master used in the medication management system according to an embodiment of the present invention. [Figure 4] FIG. 4 is a diagram showing an example of sample data used in the medication management system according to the embodiment of the present invention. [Diagram 5] FIG. 5 is a diagram showing an example of a medication history management screen displayed in the medication management system according to the embodiment of the present invention. [Figure 6] FIG. 6 is a diagram showing an example of a medication history management screen displayed in the medication management system according to the embodiment of the present invention. [Figure 7] FIG. 7 is a diagram showing an example of a question window displayed in the medication management system according to the embodiment of the present invention. [Figure 8] FIG. 8 is a diagram showing an example of a result window displayed in the medication management system according to the embodiment of the present invention. [Figure 9] FIG. 9 is a flowchart showing an example of a processing procedure of a medication management method executed in the medication management system according to the embodiment of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0012] Hereinafter, an embodiment of the present invention will be described with reference to the accompanying drawings to facilitate understanding of the present invention. Note that the following embodiment is an example of the present invention and is not intended to limit the technical scope of the present invention. In addition, the configurations and processing functions described in the following embodiment can be selected and combined as desired.

[0013] [Medication Management System 10] As shown in FIG. 1, the medication management system 10 according to the embodiment of the present invention includes a server 1, a client terminal 2, and a printer 3. The server 1, the client terminal 2, and the printer 3 are connected to each other via a communication network NT1 so as to be able to communicate wirelessly or wired. The communication network NT1 includes a local area network (LAN), a wide area network (WAN), the Internet, an intranet, and the like. A discrimination support system 4 and a higher-level system 5 are connected to the server 1 via the communication network NT1. The medication management system 10 may include at least one of the server 1, the client terminal 2, and the printer 3 in a plurality of units. Furthermore, the plurality of discrimination support systems 4 may include different types of systems, and the plurality of higher-level systems 5 may include different types of systems.

[0014] The users of the medication management system 10 are, for example, pharmacists, doctors, nurses, medical staff, or facility managers in medical institutions such as hospitals, nursing homes for the elderly, or pharmacies. In this embodiment, as an example, the medication management system 10 is used in a hospital, and the users of the medication management system 10 are pharmacists (hospital pharmacists) in the hospital.

[0015] In addition, in this embodiment, unless otherwise specified, when simply referring to a "drug" the "drug" refers to an oral drug. In other words, in this embodiment, the "drug" does not include an injection drug or an external medicine, but means only an oral drug.

[0016] In the medication management system 10, the server 1 can display various information such as medication history and adverse events for each patient on the client terminal 2 in response to a user's operation of the client terminal 2. The client terminal 2 controls the display screen based on display data transmitted from the server 1, or controls the display screen by referring to various data stored in the server 1. The server 1 can also accept operation input to the client terminal 2 by a user.

[0017] Specifically, in this embodiment, a server-client system is configured by the server 1 and the client terminal 2, and a case will be described in which the server 1 executes various processes such as display and printing in response to user operations of the client terminal 2. Therefore, in this embodiment, "display," "operation," "selection," "input," and the like described below will be described as being performed using the client terminal 2. Note that similar displays and operations may also be performed by the server 1.

[0018] The host system 5 is, for example, an electronic medical record system, an ordering system, or a medical receipt computer processing system. The host system 5 is a system separate from the medication management system 10, and it is sufficient that the host system 5 can communicate with the medication management system 10, and it is not essential that the host system 5 is in a "host" relationship with the medication management system 10. The host system 5 inputs prescription data related to the prescription or administration of medicines to patients, test data related to the test results of various tests performed on patients, and patient data related to patients to the server 1. The server 1 may be configured to actively read out the prescription data, the test data, and the patient data from the host system 5.

[0019] The discrimination support system 4 supports a drug discrimination task of confirming and identifying drugs. The discrimination support system 4 may be a system separate from the medication management system 10, and may be linked to the medication management system 10 through communication. Input of at least one of the prescription data, the test data, and the patient data to the server 1 may be performed by the discrimination support system 4 in addition to or instead of the higher-level system 5. Alternatively, at least one of the prescription data, the test data, and the patient data may be directly input to the medication management system 10 by a user's operation on the client terminal 2 or the server 1.

[0020] Here, the patient data includes at least patient identification information for identifying each patient, such as a patient ID and a patient name (first name). The patient data further includes various information related to the patient, such as the patient's age, sex, medical history, prescription drug history, whether the patient consumes alcohol, whether the patient smokes, and family information. The patient data further includes information related to the patient's medical treatment at the hospital, such as whether the patient is inpatient / outpatient, the date of admission (including the planned date of admission) and the date of discharge (including the planned date of admission), the medical department, the ward, the room, and the doctor in charge. The patient data further includes physical information such as the height, weight, and body surface area of ​​each patient, and measurement date information indicating the date of measurement of each of the physical information. The patient data may be included in the prescription data or the test data.

[0021] The prescription data includes patient identification information (patient ID, patient name), prescription date, preparation date, drug information (drug code, drug name, etc.), usage, and dosage. The prescription data may include pharmacist information for identifying an individual pharmacist, such as a pharmacist ID and a pharmacist name (name). The prescription data may also include doctor information, type of drug container (ampule containing drug solution, vial containing drug solution, vial containing powdered drug, or infusion bag, etc.), preparation content information (type and number of drug containers, syringes, and needles used in the mixed injection work, etc.), preparation procedure information (work content, dissolved drug, solvent, amount of dissolved drug, amount of solvent, amount extracted), administration date, prescription category, medical department, ward, etc.

[0022] The medication management system 10 has a function of detecting symptoms of a prescription cascade. The term "prescribing cascade" in the present disclosure refers to one of the causes of polypharmacy, and refers to a chain of prescriptions that occurs when an adverse event caused by taking a drug is mistaken for a new symptom. The term "adverse event" refers to any undesirable or unintended sign, symptom, or illness that occurs in a patient who has taken a drug, including an event whose causal relationship with the drug is unclear. In other words, an adverse event caused by a drug being taken is mistaken for a new symptom, and a new prescription is given for the adverse event, resulting in the prescription cascade in which multiple prescriptions are generated in a chain, which may ultimately lead to the polypharmacy, etc.

[0023] Figure 2 shows a schematic example of the prescription cascade. Figure 2 shows a schematic timeline of interactions between a patient (on the left side of the figure) and a medical institution (on the right side of the figure). That is, the patient visits a medical institution A (Hospital A) for a certain symptom (P1), and the medical institution A prescribes drug X to treat the symptom (P2). At this point, drug X is the only drug that the patient is to take.

[0024] Next, the patient visits medical institution B (Hospital B) due to an adverse event caused by taking drug X (P3), and medical institution B prescribes drug Y to deal with the adverse event caused by taking drug X (P4). At this point, the drugs to be taken by the patient are drug X and drug Y.

[0025] Thereafter, the patient visits medical institution C (C Hospital) due to an adverse event caused by taking drug Y (P5), and medical institution C prescribes drug Z to deal with the adverse event caused by taking drug Y (P6). At this point, the drugs to be taken by the patient are drug X, drug Y, and drug Z.

[0026] After that, the patient experiences a more serious adverse event due to taking drug Z and visits medical institution D (Hospital D) (P7). In this way, the adverse events caused by taking drug X, drug Y, and drug Z are each mistakenly recognized as new symptoms, resulting in a prescription chain. This state is called a prescription cascade. In short, the prescription cascade occurs when adverse events caused by taking medication are continually treated with different drugs.

[0027] As described above, if an adverse event caused by a certain drug is mistaken for a new symptom, another drug may be prescribed to address the adverse event, resulting in the prescription cascade, in which multiple drugs are prescribed in a chain reaction. According to the prescription cascade, a patient continues to take multiple drugs chronically, creating a vicious cycle in which symptoms (adverse events) that would be cured if the patient stopped taking the drugs worsen as the number of drugs taken increases.

[0028] The prescription cascade is not a problem with the combined use of two or more drugs prescribed to one patient, but a problem with taking the two or more drugs without noticing the causal relationship between them. Therefore, unlike a contraindication for combined use in which a problem occurs simply with the combination of the two or more drugs, the prescription cascade can occur only when secondary conditions are met, such as the occurrence of an adverse event of one of the two or more drugs, the two or more drugs being prescribed in a specific order, and / or the two or more drugs being prescribed by different medical institutions.

[0029] Furthermore, potential factors that may lead to the prescription cascade include the random administration of prescription drugs (factor 1), decreased medication adherence (factor 2), and lack of cooperation between medical institutions (factor 3).

[0030] That is, as a specific example of the first factor, when a patient is prescribed a drug for the treatment of a disease that the patient previously suffered from, and the patient's symptoms have already stabilized or been cured, and the patient no longer needs to take the drug, the drug may be administered without any consideration, resulting in the occurrence of adverse events due to the unnecessary continuation of the drug. As a specific example of the second factor, when a patient does not take the prescribed drug correctly and adherence to the drug decreases, a doctor or other medical professional may consider the drug to be ineffective and increase the dosage of the drug or prescribe an additional drug, resulting in the occurrence of adverse events. As a specific example of the third factor, when a patient visits multiple medical institutions and the doctors or other medical professionals at each medical institution are not aware of the drug prescription status, the prescription cascade may be caused by the patient mistaking the adverse events caused by taking the drug for new symptoms.

[0031] These preliminary factors suggest that prescription cascades are more likely to occur when patients meet certain criteria, such as when the patient is elderly, takes many different medications, takes antipsychotics, and / or is a psychiatric patient.

[0032] When the medication management system 10 detects a symptom of prescription cascading for a certain patient, it extracts a combination of two or more drugs suspected of prescription cascading and presents it to the user. This allows the user to take measures against prescription cascading for the patient, for example, by implementing an initiative to change the contents of the prescription. Changes to the contents of the prescription include reducing, changing, reducing the dosage, discontinuing (taking), changing to a generic drug, changing to an alternative drug, etc., for the drug to be taken.

[0033] [Client terminal 2] The client terminal 2 is a personal computer including a control unit 21, a storage unit 22, a communication I / F 23, a display unit 24, an operation unit 25, and a drive device 26. Each of the client terminals 2 is an operation terminal that is placed in a medical institution (a hospital in this embodiment) where the medication management system 10 is used, and is operated by a user. For example, the client terminal 2 is used by a pharmacist who prepares medicines to be administered to patients at the medical institution. The client terminal 2 may be a smartphone, a tablet terminal, a wearable terminal, or a portable information processing device such as a laptop computer.

[0034] The control unit 21 has control devices such as a CPU (Central Processing Unit), a ROM (Read Only Memory), a RAM (Random Access Memory), and an EEPROM (registered trademark). The CPU is a processor that executes various arithmetic operations. The ROM is a non-volatile storage unit in which information such as a control program for causing the CPU to execute various processes is stored in advance. The RAM is a volatile storage unit, and the EEPROM (registered trademark) is a non-volatile storage unit. The RAM and the EEPROM (registered trademark) are used as temporary storage memories (work areas) for various processes executed by the CPU. The control unit 21 uses the CPU to execute various processes in accordance with various control programs stored in advance in the ROM, the EEPROM (registered trademark), or the storage unit 22.

[0035] The storage unit 22 is a non-volatile storage unit such as a hard disk or SSD (Solid State Drive) in which various control programs and various data executed by the control unit 21 are stored. Specifically, the storage unit 22 includes a program storage unit in which an operating system (OS) and application programs such as browser software are stored. The browser software is application software for displaying various operation screens and the like on the display unit 24 by accessing the server 1 via the communication network NT1, and for transmitting input operations on the operation screen using the operation unit 25 to the server 1. For example, when address information such as a URL (Universal Resource Locator) corresponding to the server 1 is input at a predetermined position on the operation screen displayed by the browser software, the control unit 21 accesses the server 1 based on the address information.

[0036] The communication I / F 23 is a communication interface having a network card or the like that performs wireless or wired data communication between the server 1 and external devices such as the printer 3 via the communication network NT1 in accordance with a predetermined communication protocol.

[0037] The display unit 24 is a device such as a liquid crystal display or an organic EL (Electro-Luminescence) display that displays various information according to control instructions from the control unit 21. The operation unit 25 is a device operated by a user to input various information to the client terminal 2. Specifically, the operation unit 25 includes a keyboard and a pointing device (mouse, etc.) that accepts input operations on various operation screens displayed on the display unit 24. The operation unit 25 may also include a touch panel that accepts touch operations on various operation screens displayed on the display unit 24, or a voice input device that accepts input of various information by voice recognition. The control unit 21 then accepts user operations on the operation unit 25 and inputs the contents of the user operations to the server 1.

[0038] The drive device 26 is a device that reads the OS or the browser software from a computer-readable recording medium 261 on which the OS or the browser software is non-temporarily recorded. The drive device 26 may be integrated with the client terminal 2, or may be externally attached to the client terminal 2 by being removably connected to the client terminal 2. The recording medium 261 is a CD, DVD, BD, USB memory, or the like, and the drive device 26 is a CD drive, DVD drive, BD drive, USB port, or the like. In the client terminal 2, the control unit 21 installs the OS or the browser software read from the recording medium 261 using the drive device 26 into the program storage unit of the storage unit 22. Note that various software (programs) may be stored in advance in the storage unit 22, or the client terminal 2 may receive them from an external device via the communication network NT1.

[0039] Specifically, the server 1 transmits data described in a Web page description language such as HTML (Hyper Text Markup Language) to the client terminal 2, thereby displaying various screens on the display unit 24 of the client terminal 2. In addition, the control unit 21 of the client terminal 2 transmits an operation signal to the server 1 in response to an operation input to the operation unit 25.

[0040] [Printer 3] The printer 3 is an image forming device such as a color printer or a monochrome printer that can execute a print process to record on a sheet of paper or the like information contained in print data input from the server 1 or the client terminal 2 via the communication network NT1. For example, in a medical institution such as a hospital or a pharmacy, a prescription based on the prescription data may be printed by the printer 3.

[0041] [Identification Support System 4] The discrimination support system 4 executes a discrimination support process for checking and identifying at least the medicines brought by the patient (medicines brought by the patient). In other words, in general, when a patient is admitted to a medical institution such as a hospital, a pharmacist performs a discrimination task in advance to check and identify the medicines brought by the patient that the patient has been taking since before the admission. The discrimination support system 4 executes the discrimination support process, so that the discrimination task for such medicines brought by the patient can be automated or simplified.

[0042] In this embodiment, the "brought-in medication" will be described as including only medications prescribed at a hospital other than the hospital where the patient is admitted before hospitalization. Therefore, medications prescribed at the hospital where the patient is admitted, i.e., the hospital where the medication management system 10 is used, are not included in the "brought-in medication" even if the medication was intended for the patient to take before hospitalization. Therefore, in this embodiment, the medications taken by the patient at the time of hospitalization include both the patient's brought-in medication and medications prescribed at the hospital where the patient is admitted and intended for the patient to take before hospitalization. The discrimination support system 4 performs the discrimination support process only for the brought-in medications among the medications taken by the patient at the time of hospitalization.

[0043] 1, as an example, the discrimination support system 4 includes a photographing device 41 and a computer 42. In the discrimination support system 4, the photographing device 41 photographs medicines, and the computer 42 automatically discriminates the medicines based on image data of the photographed medicines.

[0044] The computer 42 includes a control unit, a storage unit, a communication I / F, a display unit, an operation unit (all of which are not shown), etc. The storage unit stores in advance a control program for causing the control unit to execute the discrimination support process.

[0045] When identifying medicines (medicines brought with the user in this embodiment), first, a user of the identification support system 4 sets the medicine to be identified in the photographing device 41. Next, based on the user's operation of the computer 42, the photographing device 41 photographs the medicine. Image data of the photographed image of the medicine is transmitted to the computer 42. The control unit of the computer 42 refers to a database based on the image data and searches for the medicine. The control unit may search for the medicine by referring to a database built into the computer 42, or may search for the medicine by accessing an external database via the communication I / F.

[0046] In the column "[Discrimination support system 4]", unless otherwise specified, "user" refers to a user of the discrimination support system 4, and as an example, a pharmacist (hospital pharmacist) at the hospital where the medication management system 10 is introduced. In other words, the user of the discrimination support system 4 may be the same as the user of the medication management system 10.

[0047] As a specific example, the user places the medicine brought by the patient in a petri dish of the photographing device 41. When the user performs an instruction operation for photographing processing in the photographing device 41 on the computer 42, the photographing device 41 photographs the medicine placed on the petri dish from above and below. When the control unit obtains image data from the photographing device 41, it causes the display unit to display a discrimination screen including the image.

[0048] When the discrimination of the brought-in medicine is completed, the control unit displays a list of candidate medicines obtained as a result of discrimination on the discrimination screen. The control unit narrows down the candidate medicines to be listed based on at least one of the following: type of medicine (whether it is a tablet or other medicine), shape of the medicine (whether it is round or non-round, and if it is non-round, the ratio of the length of the major axis to the minor axis), size of the medicine (diameter of the medicine if it is round, and the length of the major axis and the length of the minor axis if it is non-round), presence or absence of engraving, presence or absence of printing, presence or absence of a dividing line, and representative color of the medicine (representative color of the region with the engraving, representative color of the region with the printing, and representative color of the other region). For example, the control unit displays medicines that are more likely to be correct probabilistically in higher rows of the list.

[0049] The user selects, from the list, a candidate drug that is considered to be correct as a result of the identification of the brought-in drug, as the brought-in drug. As a result, information about the selected candidate drug becomes brought-in drug information about the brought-in drug. The brought-in drug information includes at least a drug code or drug name for identifying the drug. The user also manually inputs information about the brought-in drug, such as the usage, dosage (amount taken per day or per session), and start date of taking the brought-in drug, for example, by referring to a medicine notebook. The user also counts the quantity of the brought-in drug (amount brought in) and manually inputs it into the computer 42. The control unit registers (records) the brought-in drug information, including this manually input information.

[0050] When the registration of the brought-home drug information for one drug is completed, the user performs the discrimination process for the other brought-home drugs for which discrimination has not yet been completed in the same manner as described above. When the discrimination process for all brought-home drugs is completed in this manner, the control unit registers (records) discrimination result data. The discrimination result data includes the brought-home drug information registered in the discrimination support process for each brought-home drug.

[0051] After checking the discrimination result data, the user (pharmacist) affixes a confirmation seal (e.g., an electronic seal). Furthermore, a doctor verifies the discrimination result data that has already been stamped by the user, and affixes a confirmation seal (e.g., an electronic seal). When the doctor has completed the confirmation of the discrimination result data, the discrimination result data is registered (recorded) in the computer 42 in a state that can be output as appropriate.

[0052] The discrimination support system 4 can output the registered discrimination result data in various forms, such as display and printing. In particular, in this embodiment, the discrimination support system 4 can cooperate with the medication management system 10, and therefore can output at least a part of the discrimination result data to the server 1 of the medication management system 10. The discrimination support system 4 also outputs at least a part of the discrimination result data to the client terminal 2 as necessary. Here, the format of the discrimination result data, etc. can be appropriately changed depending on the output form and output destination.

[0053] The discrimination support system 4 does not have to include the photographing device 41. In other words, the discrimination support system 4 does not have to automate the discrimination work, and may be a system that simplifies the discrimination work. For example, a user (pharmacist, etc.) inputs an identification code marked on a medicine into an input screen of the computer 42. In this case, the computer 42 performs "Web discrimination" in which the computer 42 accesses an external database via the communication I / F based on the manually inputted identification code to discriminate the medicine.

[0054] [Server 1] 1, the server 1 is a computer including a control unit 11, a storage unit 12, a communication I / F 13, a display unit 14, an operation unit 15, and a drive device 16. The server 1 may be provided outside a medical institution such as a hospital or a pharmacy where the medication management system 10 is used. The server 1 may also be an information processing device such as a smartphone, a tablet terminal, or a laptop computer.

[0055] The control unit 11 has a configuration similar to that of the control unit 21, and has control devices such as a CPU, ROM, RAM, and EEPROM, and uses the CPU to execute various processes in accordance with various control programs pre-stored in the ROM, the EEPROM, or the memory unit 12.

[0056] The storage unit 12 is a non-volatile storage unit such as a hard disk or SSD that stores various control programs and various data executed by the control unit 11. The storage unit 12 also includes a program storage unit 121, a master storage unit 122, and an information storage unit 123.

[0057] The program storage unit 121 is a storage area in which a medication management program for causing the control unit 11 to execute various processes related to a medication management method described below and the like are stored. The program storage unit 121 also stores programs such as an operating system (OS).

[0058] The master storage unit 122 is a storage area in which various master information such as a medicine master, a patient master, a medical department master, a user master, and a caution drug master is stored. In this embodiment, the master storage unit 122 also stores a prescription cascade master D1 (see FIG. 3).

[0059] For example, the drug master includes information about various drugs, such as drug codes (including YJ codes, etc.), drug names, JAN codes, RSS codes, medicine bottle codes, dosage forms, units, specific gravity, drug varieties, compounding variations, excipients, precautions, allergy information, and package insert information. The patient master includes information about each patient, such as patient ID, patient name, age, sex, medical history, prescription drug history, alcohol use, smoking, family information, medical department, ward, room, and doctor in charge. The medical department master includes information about various medical departments of the medical institution in which the medication management system 10 is used. The user master includes information about users, such as pharmacist IDs, pharmacist names, passwords, user groups, and processing permissions.

[0060] The caution drug master includes, for each predetermined caution drug, information such as drug code, drug name, JAN code, RSS code, medicine bottle code, dosage form, unit, specific gravity, drug type, compounding variations, excipient drug, allergy information, package insert information, etc. Furthermore, the caution drug master associates caution drugs with attributes (age, etc.) of patients who need to be careful when taking the caution drug, and information such as adverse events that may occur with the caution drug.

[0061] As shown in FIG. 3, the prescription cascade master D1 includes information on a first drug ("Drug 1"), a second drug ("Drug 2"), and an adverse event (an event that should be confirmed as an adverse event of the first drug). The first drug, the second drug, and the adverse event are associated with each other as combinations that are suspicious of the prescription cascade, forming subcontents. That is, the prescription cascade master D1 stores a plurality of subcontents each consisting of a combination of the first drug, the second drug, and the adverse event that are suspected of the prescription cascade. As an example, when "dizziness, lightheadedness" occurs as an adverse event of a "sleeping pill / anxiety drug" that was previously prescribed as the first drug, and an "antidote" is prescribed as the second drug, the combination corresponds to "subcontent 4," and a symptom of the prescription cascade is suspected.

[0062] The prescription cascade master D1 is generated based on sample data D2 as exemplified in Fig. 4. The sample data D2 is a combination of two (2 drugs) or three (2 drugs) drugs, and is data that collects cases in which the prescription cascade actually occurred. The sample data D2 is formed by tallying up individual data for a combination of a first drug ("Drug 1"), an adverse event of the first drug, a second drug ("Drug 2"), an adverse event of the second drug, and a third drug ("Drug 3").

[0063] The master information stored in the master storage unit 122 is read from a computer-readable recording medium 161 by the drive device 16, for example, and stored in the storage unit 12. Various pieces of master information may be stored in advance in the storage unit 12, or the server 1 may receive the master information from an external device via the communication network NT1. The control unit 11 can update the various pieces of master information stored in the master storage unit 122 at any time based on information acquired from the higher-level system 5. The control unit 11 can also edit the various pieces of master information in response to a user operation using the server 1 or the client terminal 2.

[0064] The information storage unit 123 is a storage area in which various information such as the prescription data, the test data, the patient data, the discrimination result data, and the medication history data is stored. The control unit 11 acquires the prescription data, the test data, the patient data, the discrimination result data, and the like from the upper system 5 or the discrimination support system 4, and accumulates and stores them in the information storage unit 123.

[0065] The control unit 11 updates various data in the information storage unit 123 based on data acquired from the higher-level system 5 (or the discrimination support system 4) or data read from the recording media 161, 261 by the server 1 (or the client terminal 2). Alternatively, the control unit 11 may update various data in the information storage unit 123 based on data directly input to the medication management system 10 by a user's operation on the client terminal 2 or the server 1.

[0066] The test data is information including test results such as test values ​​for each test item performed on each patient. For example, the test data includes information such as a patient ID (patient identification information), a patient name (patient identification information), a test date, a test ID (test identification information), a test item (test identification information), and test results.

[0067] The medical history data is information indicating the drug taking history of each patient. The medical history data includes information such as a patient ID (patient identification information), a patient name (patient identification information), a start date of taking the drug, a date of taking the drug, a prescription date, drug information (drug code, drug name, etc.), usage, and dosage. The medical history data may further include information such as the pharmacist information, the doctor in charge, the medical department, and the ward. According to the medical history data, it is possible to know at least "when" and "which drug" the patient took in chronological order.

[0068] The control unit 11 updates the medical history data in the information storage unit 123 based on at least one of the prescription data and the discrimination result data. The control unit 11 can also edit the medical history data in response to a user operation using the server 1 or the client terminal 2. That is, the control unit 11 can record the medical history of each patient by editing the medical history data in response to a user operation. Therefore, the medical history data may include information on future medication schedules and past medical history. Specifically, the control unit 11 can edit the medical history data in response to a user operation on a medical history management screen Dp1 (see FIG. 5) described later.

[0069] The control unit 11 updates various data in the information storage unit 123, for example, when new data occurs in the higher-level system 5, when a preset time arrives, when a preset time interval has elapsed, or when an update operation is performed by the user.

[0070] The communication I / F 13 is a communication interface having a network card or the like that executes wireless or wired data communication in accordance with a predetermined communication protocol between the client terminal 2 and external devices such as the printer 3 via the communication network NT1. The communication I / F 13 also performs data communication between the discrimination support system 4 and the higher-level system 5.

[0071] The display unit 14 is a device such as a liquid crystal display or an organic EL display that displays various information according to control instructions from the control unit 11. The operation unit 15 has a similar configuration to the operation unit 25, and is a device operated by a user to input various information to the server 1. The control unit 11 accepts a user operation on the operation unit 15, and executes processing according to the content of the user operation.

[0072] The drive device 16 has a configuration similar to that of the drive device 26, and is a device that reads the medication management program from a computer-readable recording medium 161 on which the medication management program is non-temporarily recorded. Then, in the server 1, the control unit 11 installs the medication management program read from the recording medium 161 using the drive device 16 into the program storage unit 121 of the storage unit 12. The medication management program may be stored in the storage unit 12 in advance, or the server 1 may receive it from an external device via the communication network NT1.

[0073] Incidentally, the control unit 11 of the server 1 includes an acquisition processing unit 111, a first judgment processing unit 112, a second judgment processing unit 113, a selection processing unit 114, and an output processing unit 115, as shown in FIG. 1. Specifically, the control unit 11 executes various processes related to a medication management method described later according to the medication management program, thereby functioning as various processing units such as the acquisition processing unit 111, the first judgment processing unit 112, the second judgment processing unit 113, the selection processing unit 114, and the output processing unit 115. That is, in this embodiment, the server 1 embodies the main functions of the medication management system 10. In other words, the medication management system 10 according to this embodiment only needs to include the server 1, and the client terminal 2 and the printer 3 may not be included as components. The control unit 11 may include a plurality of processors, and any of the plurality of processors may function as the various processing units. In addition, a part or all of the various processing units may be configured with an electronic circuit.

[0074] In another embodiment, some or all of the functions of the server 1 may be provided in the client terminal 2. For example, some or all of the medication management program may be installed in the client terminal 2, and the control unit 21 of the client terminal 2 may acquire necessary information from the server 1 as appropriate and execute various processes related to the medication management method described below. In this case, the client terminal 2 embodies the main functions of the medication management system 10. Furthermore, in the medication management system 10, the server 1 and the client terminal 2 may cooperate to execute various processes related to the medication management method described below.

[0075] The acquisition processing unit 111 executes an acquisition process (acquisition step) for acquiring drug information D11 (see FIG. 5). The drug information D11 is information related to drugs to be taken by a patient. Specifically, the acquisition processing unit 111 is capable of acquiring the drug information D11 from various information such as the prescription data, the test data, the patient data, the discrimination result data, and the medication history data stored in the information storage unit 123. The drug information D11 includes information for identifying individual drugs, such as at least a drug code and a drug name.

[0076] The timing when the acquisition processing unit 111 acquires the medicine information D11 is, for example, a timing related to the start of hospitalization of a patient. That is, the acquisition processing unit 111 acquires the medicine information D11 at the timing when the patient starts "hospitalization", for example, at the "admission date" (including the planned date of admission).

[0077] In addition, as described below ([Other configuration examples of the identification work]), when a user (pharmacist, etc.) identifies the brought-in medicine by visual inspection, etc., the acquisition processing unit 111 acquires the identification result data including the brought-in medicine information, for example, from the client terminal 2.

[0078] The first determination processing unit 112 executes a first determination process (first determination step) for determining whether or not a combination of two or more drugs to be taken by a patient satisfies a first determination condition. The first determination condition is, for example, that the combination of two or more drugs corresponds to a combination suspected of the prescription cascade. Specifically, the first determination processing unit 112 determines whether or not the first determination condition is satisfied for the drug information D11 acquired by the acquisition processing unit 111, with reference to the prescription cascade master D1. Here, when the drug information D11 includes a combination of two or more drugs specified in any of the subcontents of the prescription cascade master D1, the first determination processing unit 112 determines that the combination of two or more drugs satisfies the first determination condition.

[0079] The second determination processing unit 113 executes a second determination process (second determination step) for determining whether or not a second determination condition related to the two or more drugs is satisfied. The second determination condition is, for example, a secondary condition for the two or more drugs that makes the prescription cascade suspected. That is, as described above ([Medication management system 10]), the prescription cascade may occur when secondary conditions such as an adverse event of any of the two or more drugs, the two or more drugs being prescribed in a specific order, and / or the two or more drugs being prescribed at different medical institutions are satisfied, unlike a contraindication for combined use. Therefore, the second determination processing unit 113 performs a determination on the secondary condition. Specifically, the second determination processing unit 113 refers to the prescription cascade master D1 and determines whether or not an adverse event of the first drug is occurring for the two or more drugs that are determined by the first determination processing unit 112 to satisfy the first determination condition. Here, if an adverse event specified in the subcontent (an event that should be confirmed as an adverse event of the first drug) occurs with respect to the first drug prescribed earlier among the two or more drugs, the second judgment processing unit 113 judges that the second judgment condition is satisfied.

[0080] The narrowing down processing unit 114 executes a narrowing down process (narrowing down step) that narrows down based on narrowing down conditions related to the patient. That is, as described above ([Medication Management System 10]), when a patient satisfies a specific condition, the prescription cascade tends to occur more easily due to the preliminary factors of the prescription cascade. Therefore, in this embodiment, the narrowing down processing unit 114 narrows down the patients for whom the symptoms of the prescription cascade are to be confirmed based on the narrowing down conditions, thereby removing noise components and enabling the symptoms of the prescription cascade to be found efficiently and accurately. Specifically, the narrowing down processing unit 114, for example, when the patient is elderly, when there are many types of drugs to be taken (for example, "6 or more drugs"), when the patient is taking an antipsychotic drug, and / or when the patient is a psychiatric patient, etc., considers the patient to be a target for checking the symptoms of the prescription cascade as satisfying the narrowing down conditions.

[0081] The output processing unit 115 executes an output process (output step) of outputting a determination result indicating that the prescription cascade is suspected for the patient when both the first determination condition and the second determination condition are satisfied. That is, when it is determined that the determination conditions (the first determination condition and the second determination condition) are satisfied in both the first determination processing unit 112 and the second determination processing unit 113, the output processing unit 115 outputs the determination result indicating that the prescription cascade is suspected for the patient. Specifically, the output processing unit 115 outputs the determination result by displaying the medication history management screen Dp1 including the determination result on, for example, the display unit 24 of the client terminal 2. That is, in this embodiment, the aspect of the "output" related to the output process is "presentation" to the user, and more specifically, "display".

[0082] However, the form of "output" related to the output process is not limited to display, and may include, for example, printing, audio output, data output, transmission to other systems (other devices), writing to a database, and writing to a memory. For example, the output processing unit 115 may output the determination result to a device (including the discrimination support system 4 and the higher-level system 5) other than the medication management system 10. In this embodiment, the output processing unit 115 can output the determination result by, for example, printing a drug information sheet, in addition to displaying it. In this case, the output processing unit 115 outputs (sends) print data including the determination result to the printer 3.

[0083] In this way, when the prescription cascading is suspected for the patient, the determination result indicating that the prescription cascading is suspected for the patient is automatically output, which reduces the workload of the user (pharmacist, etc.) involved in discovering the symptoms of the prescription cascading.

[0084] [Medication management method] An example of the medication management method executed by the control unit 11 of the server 1 will be described below. The control unit 11 executes various processes related to the medication management method when a preset specific start operation for executing the medication management program is performed on the client terminal 2. When the specific start operation is performed on a plurality of the client terminals 2, the control unit 11 can execute the medication management method substantially in parallel for each of the client terminals 2. The medication management method may be terminated in response to a specific end operation on the client terminal 2 even during execution of the medication management method. The present invention may be understood as an invention of a method (medication management method) for executing part or all of the processes of the medication management method by a computer such as the server 1.

[0085] Here, the start operation includes connection of the client terminal 2 to the server 1 (launch of application software) and login involving input of a user ID and password, while the end operation includes logout and disconnection between the server 1 and the client terminal 2.

[0086] Furthermore, the control unit 11 of the server 1 basically executes the medication management method using a screen displayed on the display unit 24 of the client terminal 2. In this disclosure, "screen" refers to an image (picture) displayed on the display unit 24 (or the display unit 14) or the like, and includes icons, figures, photographs, text, videos, etc. The main screens displayed on the display unit 24 include the medication history management screen Dp1.

[0087] Note that buttons on a screen, such as the registration button B11, are objects included in a screen displayed on the display unit 24, and an operation of the button is an operation of the operation unit 25 to select the button. For example, a user can operate the registration button B11 by performing an operation on the operation unit 25, such as placing a cursor on the registration button B11 in the medication history management screen Dp1 and clicking it, or touching the registration button B11 in the medication history management screen Dp1. Also, in drawings showing screens displayed on the display unit 24, such as FIG. 5, the dashed dotted lines, leader lines, and reference symbols representing areas are added only for the purpose of explanation, and are not actually displayed on the display unit 24.

[0088] In this embodiment, the medication management method basically checks for signs of prescription cascade in conjunction with the discrimination work at the timing related to the start of hospitalization of a patient. Specifically, at the timing when a patient starts "hospitalization", for example, at the "admission date" (including the planned date of admission), the acquisition processing unit 111 acquires the drug information D11 and generates the medication history management screen Dp1 using the acquired drug information D11. Then, while the medication history management screen Dp1 is displayed on the display unit 24, the first determination processing unit 112 and the second determination processing unit 113, etc. operate in the background to check for signs of prescription cascade.

[0089] As shown in FIG. 5, the medication history management screen Dp1 includes an information display area R11, a button group area R12, and a patient information area R13. The information display area R11 displays the medication information D11 for one patient. The button group area R12 displays a plurality of buttons to be operated by the user. Specifically, the button group area R12 displays the registration button B11, the print button B12, the patient memo button B13, the check button B14, and the back button B15. The patient information area R13 displays information about the patient for whom the medication information D11 and the like are displayed in the information display area R11. Specifically, the patient information area R13 displays a patient ID, a patient name, a ward, a medical department, hospitalization / outpatient, admission date, discharge date, pharmacist information, doctor information, and the like.

[0090] More specifically, in the present embodiment, as an example, the information display area R11 displays a plurality of medicines arranged vertically (up and down) such that each row corresponds to an individual medicine. A slide bar Sb11 is provided at the right end of the information display area R11, and the display contents of the information display area R11 can be scrolled vertically in response to the operation of the slide bar Sb11.

[0091] In the information display area R11, the first information display area R111 and the second information display area R112 are both divided horizontally (left and right) into a plurality of columns C101 to C112, and information about each drug is displayed in the plurality of columns C101 to C112. The column C101 displays a check box for selection, the column C102 displays whether the drug is brought with the patient, the column C103 displays the drug name, the column C104 displays the daily dosage, the column C105 displays the unit, the column C106 displays the start date of the drug, the column C107 displays the method of use, and the column C108 displays the number of days the drug is taken. The number of days the drug is taken indicates the number of days the drug is taken, that is, how many days the drug is taken from the start date of the drug. Furthermore, the column C109 displays the number of cautions, the column C110 displays whether the drug is an antipsychotic drug, the column C111 displays the management category, and the column C112 displays the reason / progress.

[0092] In the column C102, "Keep" is displayed for the medicine cited from the discrimination result data (i.e., the brought-in medicine) or the medicine cited from the discrimination support system 4 by operating the brought-in medicine button B102, and the other medicines are blank. The column C109 is operated to call up the information of the caution medicine master to which the medicine belongs. In this embodiment, the input of the columns C101 to C112 is basically performed automatically, for example, by linking with the upper system 5. However, the input of at least one of the columns C101 to C112 may be performed manually by the user. For example, the column C112 can be automatically inserted by the reason / progress management process, but the user can also manually input information. As an example, for the medicine that has been discontinued, the text "Discontinued" is entered in the column C112, and for the medicine that has been reduced, the text "Reduced" is entered in the column C112.

[0093] In addition, at the top of the information display area R11, a Do button B101, the brought-in medication button B102, a calculation button B103, a row insert button B104, a row delete button B105, and a sort order button B106 are displayed. The Do button B101 is a button for displaying the prescription history of the patient, and any medicine can be quoted from the prescription history to the information display area R11. The brought-in medication button B102 is a button for displaying a discrimination call screen in cooperation with the discrimination support system 4, etc., and any medicine can be quoted from the discrimination call screen to the information display area R11. The calculation button B103 is a button for executing CPZ conversion. The row insert button B104 is a button for adding a row, i.e., a medicine, to the information display area R11, and the row delete button B105 is a button for deleting information from the information display area R11 by row, i.e., by medicine. The sort order button B106 is a button for changing the sort order of the selected medicines.

[0094] Furthermore, the number of target drugs and the CPZ equivalent value are displayed between the brought-medicine button B102 and the calculation button B103. The number of target drugs is the total number of drugs included in the information display area R11, and the CPZ equivalent value is the CPZ equivalent value of the drugs included in the information display area R11.

[0095] The registration button B11 in the button group area R12 is a button for registering information displayed in the information display area R11. The print button B12 is a button for printing a drug information sheet. The patient memo button B13 is a button for moving to a patient memo screen for inputting a patient memo, and the back button B15 is a button for moving to the previous screen.

[0096] The check button B14 is a button for checking the presence or absence of the indication of the prescription cascade. The check button B14 is inactivated by being grayed out, for example, by default (see FIG. 5), and is in an inoperable state. In contrast, when a combination of two or more drugs included in the drug information D11 satisfies the first judgment condition, the check button B14 is displayed as active (see FIG. 6) and becomes operable. As another example, instead of the check button B14, a first judgment button for executing the first judgment process and a second judgment button for executing the second judgment process may be provided. Alternatively, the check button B14 may be displayed as active regardless of whether the first judgment condition is satisfied, and when the check button B14 is operated, the first judgment process and the second judgment process may be automatically executed in succession.

[0097] The medical history management screen Dp1 can be edited as needed. For example, when a prescription is changed to discontinue the administration of a certain medicine during hospitalization of a patient, the user edits the medical history management screen Dp1 at that time.

[0098] Meanwhile, while the medical history management screen Dp1 is displayed, the first determination processing unit 112 extracts a combination of two or more medicines that satisfies the first determination condition from the medicines that are included in the medicine information D11 and are taken by the patient. At this time, the first determination processing unit 112 determines whether or not the medicine information D11 includes a combination of two or more medicines that is specified in any of the subcontents of the prescription cascade master D1.

[0099] As an example, assume that "Drug C 75 mg" in the drug information D11 in FIG. 5 is a sleeping pill / anxiety drug, and "Drug E 200 mg" is an anti-vertigo drug. In this case, the combination of "Drug C 75 mg" and "Drug E 200 mg" corresponds to the combination of two drugs ("Sleeping pill / anxiety drug" and "Anxiety drug") defined in "Subcontent 4" of the prescription cascade master D1. Therefore, the first determination processing unit 112 determines that the combination of "Drug C 75 mg" and "Drug E 200 mg" satisfies the first determination condition.

[0100] If the medicine information D11 does not include a combination of two or more medicines defined in any of the subcontents of the prescription cascade master D1, the first determination processing unit 112 determines that the first determination condition is not satisfied. In this case, the subsequent processes including the operation of the second determination processing unit 113 are not executed.

[0101] When the first determination processing unit 112 extracts a combination of two or more drugs that satisfies the first determination condition, the first determination processing unit 112 highlights the two or more drugs on the medical history management screen Dp1 as shown in FIG. 6. The highlighting is realized, for example, by changing the display color of the record (row) of the corresponding drug name in the drug information D11 of the medical history management screen Dp1 to, for example, red, so as to display the record in a manner that can be distinguished from other drugs. Here, the first drug and the second drug may be displayed in a manner that can be distinguished. For example, if the prescription order of the first drug and the second drug is known, the display color of the record of the drug name prescribed first is set to blue, and the display color of the record of the drug name prescribed later is set to red, so that the display mode of the first drug and the second drug is made different. At this time, since the combination of two or more drugs included in the drug information D11 satisfies the first determination condition, the first determination processing unit 112 makes the check button B14 of the medical history management screen Dp1 active.

[0102] Then, when the check button B14 is operated on the medical history management screen Dp1 shown in FIG. 6, the second determination processing unit 113 starts determining the second determination condition, which is a secondary condition that indicates the suspicion of prescription cascade, for the two or more drugs. In this embodiment, the second determination processing unit 113 displays a question window W1 as shown in FIG. 7 on the display unit 24, and performs determination of the second determination condition based on a user operation on the question window W1. In the example of FIG. 7, the question window W1 is displayed as a pop-up window superimposed on the medical history management screen Dp1. However, this is not limited to this example, and the medical history management screen Dp1 may be switched to the question window W1.

[0103] Thus, in this embodiment, when the first judgment condition is satisfied, the second judgment processing unit 113 makes a presentation to ask the user whether or not the second judgment condition is satisfied. Here, the manner of "presentation" is not limited to displaying the question window W1 or the like, but may include, for example, printing, audio output, data output, transmission to another system (another device), writing to a database, writing to a memory, and the like. By making such a presentation, the user (pharmacist, etc.) can, for example, interview the patient and relatively easily obtain information necessary for judging the second judgment condition.

[0104] 7, the question window W1 includes three question items: "(1) Are sleeping pills / anti-anxiety drugs prescribed before anti-vertigo drugs?", "(2) Are anti-vertigo drugs prescribed to treat dizziness / lightheadedness caused by the prescribed sleeping pill / anti-anxiety drug?", and "(3) Are sleeping pills / anti-anxiety drugs prescribed at a medical institution different from the anti-vertigo drugs?". In other words, the second determination condition includes conditions related to these three items.

[0105] Each of the three items is provided with a check box marked "Yes" or "No," and the user answers the three items by checking either the "Yes" or "No" check box for each of the three items. The second determination processing unit 113 determines that the second determination condition is met only when all of the three items are answered with "Yes."

[0106] The question item (1) above is an item for confirming the prescription order of the combination of two or more drugs suspected of the prescription cascade, that is, the prescription order of a sleeping pill / anxiolytic (drug C 75 mg) and an antidote (drug E 200 mg). That is, the second judgment condition includes an order condition related to the prescription order of the two or more drugs. In short, the prescription cascade can only occur when a secondary condition, such as the two or more drugs being prescribed in a specific order, is satisfied, so by including the secondary condition in the second judgment condition, the detection accuracy of the prescription cascade is improved.

[0107] In particular, the question item (1) above asks whether the hypnotic / anxiolytic that is the basis of the adverse event is prescribed before the other drug, the antidote. In other words, the second determination processing unit 113 determines that the order condition is satisfied when the prescription order is an order that indicates a causal relationship between the two or more drugs. Therefore, the order condition is satisfied only when a secondary condition that the two or more drugs are prescribed in an order that indicates a causal relationship is satisfied, and the detection accuracy of the prescription cascade is improved.

[0108] The question item (2) above is an item for confirming whether an adverse event (dizziness, lightheadedness) of the hypnotic / anxiety drug (Drug C 75 mg) has occurred, and further, whether an antidote (Drug E 200 mg) has been prescribed to deal with the adverse event. That is, the second judgment condition includes an event condition related to an adverse event caused by at least one of the two or more drugs. In the prescription cascade master D1 illustrated in FIG. 3, "dizziness, lightheadedness" is specified as an event to be confirmed as an adverse event of the first drug (hypnotic / anxiety drug), so the event condition is that "dizziness, lightheadedness" has occurred as an adverse event of the hypnotic / anxiety drug. The prescription cascade is a chain of prescriptions that occurs when an adverse event caused by a certain drug is misidentified as a new symptom, and another drug is prescribed to deal with the adverse event. Therefore, by including a condition related to the adverse event in the second judgment condition, the detection accuracy of the prescription cascade is improved.

[0109] Moreover, the question item (3) above is an item for confirming whether the prescribing source of the sleeping pill / anxiety drug (drug C 75 mg) is different from the prescribing source of the antidote (drug E 200 mg). In other words, the second judgment condition includes a prescribing source condition related to the prescribing source of each of the two or more drugs. The prescription cascade can only occur when a secondary condition is satisfied, that is, the two or more drugs are prescribed by different medical institutions. Therefore, by including the secondary condition in the second judgment condition, the detection accuracy of the prescription cascade is improved.

[0110] Then, when the answer to all the three items in the question window W1 shown in FIG. 7 is "Yes," the second judgment processing unit 113 judges that the second judgment condition is satisfied. That is, in this case, since both the first judgment condition and the second judgment condition are satisfied, the output processing unit 115 outputs the judgment result indicating that the prescription cascade is suspected for the patient. Specifically, the output processing unit 115 displays a result window W2 as shown in FIG. 8 on the display unit 24. Note that, in the example of FIG. 8, the result window W2 is displayed as a pop-up window superimposed on the medication history management screen Dp1. However, this is not limited to this example, and the medication history management screen Dp1 may be switched to the result window W2.

[0111] In the example of Fig. 8, the result window W2 includes the result "Signs of prescription cascade are seen," as well as two items as countermeasures to the prescription cascade: "(Countermeasure 1) Reconsider the need for anti-nausea medication," and "(Countermeasure 2) Consider alternative medications or reduction of the sleeping pill / anti-anxiety medication." This allows the user to know not only that the signs of prescription cascade are seen, but also specific countermeasures to the prescription cascade.

[0112] Furthermore, in the medication management method according to the present embodiment, the narrowing down processing unit 114 narrows down the patients for whom the first judgment processing unit 112 should execute the first judgment processing based on the narrowing down conditions related to the patients. That is, the narrowing down processing unit 114 narrows down the patients for whom the signs of prescription cascade are to be checked based on the narrowing down conditions, for example, based on information such as the patient's age, prescription drug history, and medical department included in the patient data. Specifically, the narrowing down processing unit 114 considers that, for example, a patient is "70 years old or older" and takes "6 or more drugs," the narrowing down conditions are met, and the patient is checked for the signs of prescription cascade. This removes noise components, making it possible to find the signs of prescription cascade more efficiently and accurately than when the signs of prescription cascade are checked for all patients.

[0113] As described above, according to the medication management system 10 and the medication management method of the present embodiment, it is possible to detect the symptoms of prescription cascade, which is one of the causes of polypharmacy, regardless of the user's level of proficiency. When the symptoms of prescription cascade are detected, for example, the pharmacist can take measures such as proposing a change in prescription to the doctor for the drug showing the symptoms of prescription cascade. Alternatively, when the symptoms of prescription cascade are detected, for example, the pharmacist can hand over the drug showing the symptoms of prescription cascade to the doctor along with the discrimination result data at the time of hospitalization, and the doctor can use it for treatment and / or prescription at the time of hospitalization.

[0114] However, the order of the first determination process by the first determination processing unit 112 and the second determination process by the second determination processing unit 113 may be reversed. In other words, after the second determination process by the second determination processing unit 113 is performed, the first determination process by the first determination processing unit 112 may be performed to extract a combination of two or more drugs suspected of prescription cascade.

[0115] Furthermore, depending on the contents of the prescription cascade master D1, it is not necessary to separately execute the first determination process by the first determination processing unit 112 and the second determination process by the second determination processing unit 113. That is, the medication management system 10 only needs to extract a combination of two or more drugs suspected of being a prescription cascade from among a plurality of drugs to be taken by one patient.

[0116] Hereinafter, with reference to FIG. 9, an example of a procedure of the processing of the control unit 11 related to the medication management method will be described.

[0117] <Step S1> In step S1, the acquisition processing unit 111 of the control unit 11 acquires the drug information D11 (acquisition step). At this time, the acquisition processing unit 111 acquires the drug information D11 from various information such as the prescription data, the test data, the patient data, the discrimination result data, and the medication history data stored in the information storage unit 123. Alternatively, when a user (pharmacist, etc.) discriminates the brought-in drug by visual inspection or the like, the acquisition processing unit 111 acquires the discrimination result data including the brought-in drug information as the drug information D11 acquired, for example, from the client terminal 2. Alternatively, the acquisition processing unit 111 may acquire the drug information D11 from, for example, direct input by the client terminal 2, an electronic medicine notebook, a My Number Portal, or another medical institution.

[0118] <Step S2> In step S2, the control unit 11 generates and displays the medication history management screen Dp1 by using the medication information D11. Specifically, the control unit 11 causes the display unit 24 of the client terminal 2 to display the medication history management screen Dp1 including the medication information D11.

[0119] <Step S3> In the next step S3, the narrowing down processing unit 114 of the control unit 11 narrows down the patients who are confirmed to have the symptoms of the prescription cascade based on the narrowing down conditions (narrowing down step). That is, for example, if the patient is elderly, takes many types of medicines (for example, "6 or more drugs"), takes antipsychotic drugs, and / or is a psychiatric patient, the narrowing down processing unit 114 determines that the narrowing down conditions are met (S3: Yes) and shifts the process to step S4. On the other hand, if the narrowing down conditions are not met (S3: No), the control unit 11 ends a series of processes related to confirmation of the prescription cascade.

[0120] <Step S4> In step S4, the first determination processing unit 112 of the control unit 11 determines whether or not the combination of two or more drugs to be taken by the patient satisfies the first determination condition (first determination step). If the drug information D11 includes a combination of two or more drugs specified in any of the subcontents of the prescription cascade master D1, the first determination processing unit 112 determines that the combination of two or more drugs satisfies the first determination condition (S4: Yes), and shifts the process to step S5. On the other hand, if the first determination condition is not satisfied (S4: No), the control unit 11 ends a series of processes related to confirmation of the prescription cascade.

[0121] <Step S5> In the step S5, the first determination processing unit 112 of the control unit 11 actively displays the check button B14 on the medical history management screen Dp1. In this state, if the check button B14 is operated (S5: Yes), the second determination processing unit 113 of the control unit 11 shifts the process to step S6. On the other hand, if the check button B14 is not operated (S5: No), the control unit 11 ends a series of processes related to confirmation of the prescription cascade.

[0122] <Step S6> In step S6, the second judgment processing unit 113 of the control unit 11 judges whether the second judgment condition is satisfied (second judgment step). At this time, the second judgment processing unit 113 displays the question window W1 and judges whether the second judgment condition is satisfied based on the user's answer to the question window W1. If the user answers all three items in the question window W1 with "Yes", the second judgment processing unit 113 judges that the second judgment condition is satisfied (S6: Yes) and moves the process to step S7. On the other hand, if the user answers any one of the three items in the question window W1 with "No", the second judgment processing unit 113 judges that the second judgment condition is not satisfied (S6: No), and the control unit 11 ends a series of processes related to the confirmation of the prescription cascade.

[0123] <Step S7> In the step S7, the output processing unit 115 of the control unit 11 outputs a determination result indicating that the prescription cascade is suspected for the patient (output step). Specifically, the output processing unit 115 causes the display unit 24 of the client terminal 2 to display the result window W2 indicating that the prescription cascade is suspected.

[0124] The above flowchart is merely an example, and processes may be added or omitted as appropriate, and the order of processes may be changed as appropriate. For example, the process of step S3 (the narrowing down step) may be performed at any timing, may be performed by interrupting other steps, or may not be performed at all.

[0125] [Other configuration examples for identification work] The method of distinguishing the brought-in medicines is not limited to the above-mentioned method using the distinction support system 4 (automatic distinction). For example, the method may be a method in which a user (such as a pharmacist) visually checks and distinguishes the brought-in medicines (manual distinction) without using the distinction support system 4. In this case, the user manually distinguishes the brought-in medicines and then manually inputs the brought-in medicine information into, for example, the client terminal 2.

[0126] [Variations] A plurality of components included in the medication management system 10 may be distributed among a plurality of housings. For example, at least one of the components of the server 1, such as the acquisition processing unit 111, the first determination processing unit 112, the second determination processing unit 113, the narrowing down processing unit 114, and the output processing unit 115, may be provided in the client terminal 2 or other devices (including the printer 3, the discrimination support system 4, and the upper system 5). In this case, the medication management program is distributed and installed in, for example, the server 1 and the client terminal 2, and the medication management method is executed by the server 1, the client terminal 2, and the like in cooperation with each other.

[0127] Conversely, in the above embodiment, a plurality of components that are distributed among the server 1, the client terminal 2, the printer 3, etc. may be integrated into one housing. For example, all of the functions of the server 1, the client terminal 2, and the printer 3 may be integrated into one device.

[0128] In addition, the medication management method does not necessarily check the indication of the prescription cascade in conjunction with the discrimination work at the timing related to the start of hospitalization of a patient. For example, the indication of the prescription cascade may be checked at the time of registering the drug information D11 in an electronic medical record, at the time of registering the drug information D11 at a facility, or at any other timing. As an example, at the timing when a doctor creates the prescription data (prescription order), the medication management method may check the indication of the prescription cascade by setting a drug (recently taken or currently taken) included in a medical history as the first drug and a drug of an order candidate to be prescribed from now on as the second drug. As another example, at the time of a doctor's examination, the medication management method may check the indication of the prescription cascade for a drug (recently taken or currently taken) included in a medical history. As yet another example, the indication of the prescription cascade may be checked for a plurality of hospitalized patients at the timing of reducing the dosage as a measure against polypharmacy. In this case, it is preferable to create a list of patients who show symptoms of the prescription cascade as a prescription cascade list. Alternatively, a list of patients who satisfy the first judgment condition but are unclear as to whether they satisfy the second judgment condition may be created as a check-required list, and the second judgment processing unit 113 may display the question window W1 for the patients on the check-required list.

[0129] In the above embodiment, the term "drug" is described as referring to oral medication in principle, but the term "drug" may include at least one of an injection drug and an external medicine in addition to or instead of an oral medication. For example, when the term "drug" includes oral medication, injection drug, and external medicine, the information display area R11 of the medical history management screen Dp1 may include information on all of the oral medication, injection drug, and external medicine. However, in this case, it is preferable that the management classification column C111 or the like can be used to distinguish between oral medication, injection drug, and external medicine for each drug.

[0130] In the above embodiment, it has been described that "brought-in medications" include only medications prescribed at a hospital other than the hospital where the patient is admitted before hospitalization, but "brought-in medications" may also include medications that have been prescribed at the hospital where the patient is admitted and that the patient has been taking since before hospitalization. In other words, "brought-in medications" may include both medications that have been prescribed at a hospital other than the hospital where the patient is admitted before hospitalization and medications that have been prescribed at the hospital where the patient is admitted. In this case, medications that the patient has been taking since before hospitalization can be "brought-in medications" regardless of where they were prescribed. In this way, when "brought-in medications" include medications prescribed at the hospital where the patient is admitted, the medication information D11 on the medication history management screen Dp1 will basically include only information regarding brought-in medications.

[0131] The information display area R11 of the medical history management screen Dp1 may include information on drugs that have been added to the patient's medication during the patient's hospitalization. In this case, the information display area R11 of the medical history management screen Dp1 may list drugs that have been added to the patient's medication before hospitalization and drugs that have been added to the patient's medication after hospitalization and before discharge. However, in this case, it is preferable that the patient's medication before hospitalization and the patient's medication after hospitalization can be distinguished by, for example, a column C102 indicating whether the drug was brought with the patient or not or a column C106 indicating the medication start date.

[0132] Furthermore, the second determination processing unit 113 is not limited to a configuration that presents a question to the user as to whether or not the second determination condition is satisfied, and may automatically execute a determination as to whether or not the second determination condition is satisfied. For example, when the second determination processing unit 113 has already acquired data related to the second determination condition (presence or absence of an adverse event, etc.), the second determination processing unit 113 automatically determines whether or not the second determination condition is satisfied based on the data. When the data does not exist, the second determination processing unit 113 may present a question to the user as to whether or not the second determination condition is satisfied (see FIG. 7).

[0133] [Appendix to the invention] The following will provide an overview of the invention extracted from the above-described embodiment. Note that the configurations and processing functions described in the following supplementary notes can be selected and combined as desired.

[0134] <Appendix 1> a first determination processing unit that determines whether or not a combination of two or more medicines to be taken by a patient satisfies a first determination condition; A second determination processing unit that determines whether a second determination condition related to the two or more medicines is satisfied. Medication management system.

[0135] <Appendix 2> The second judgment condition includes an event condition related to an adverse event caused by at least one of the two or more drugs. 2. A medication management system as described in appendix 1.

[0136] <Appendix 3> The second determination condition includes an order condition related to a prescription order of the two or more medicines. A medication management system as described in appendix 1 or 2.

[0137] <Appendix 4> The second determination processing unit determines that the order condition is satisfied when the prescription order is an order that indicates a causal relationship between the two or more medicines. 4. A medication management system as described in appendix 3.

[0138] <Appendix 5> The second determination condition includes a prescription source condition related to a prescription source of each of the two or more drugs, 5. The medication management system according to any one of claims 1 to 4.

[0139] <Appendix 6> The second determination processing unit, when the first determination condition is satisfied, presents a message to a user asking whether the second determination condition is satisfied. 6. A medication management system according to any one of appendices 1 to 5.

[0140] <Appendix 7> Further comprising a filtering processing unit that performs filtering based on filtering conditions related to the patient. 7. A medication management system according to any one of appendices 1 to 6.

[0141] <Appendix 8> and an output processing unit that outputs a determination result indicating that prescription cascading is suspected for the patient when both the first determination condition and the second determination condition are satisfied. A medication management system according to any one of appendices 1 to 7.

Claims

1. a first determination processing unit that determines whether or not a combination of two or more medicines to be taken by a patient satisfies a first determination condition; A second determination processing unit that determines whether a second determination condition related to the two or more drugs is satisfied. Medication management system.

2. The second judgment condition includes an event condition related to an adverse event caused by at least one of the two or more drugs. The medication management system according to claim 1.

3. The second determination condition includes an order condition related to a prescription order of the two or more medicines. The medication management system according to claim 1 or 2.

4. The second determination processing unit determines that the order condition is satisfied when the prescription order is an order that indicates a causal relationship between the two or more medicines. The medication management system according to claim 3.

5. The second determination condition includes a prescription source condition related to a prescription source of each of the two or more drugs. The medication management system according to claim 1 or 2.

6. The second determination processing unit, when the first determination condition is satisfied, presents a message to a user asking whether the second determination condition is satisfied. The medication management system according to claim 1 or 2.

7. Further comprising a filtering processing unit that performs filtering based on filtering conditions related to the patient. The medication management system according to claim 1 or 2.

8. and an output processing unit that outputs a determination result indicating that prescription cascading is suspected for the patient when both the first determination condition and the second determination condition are satisfied. The medication management system according to claim 1 or 2.

9. Extracting combinations of two or more drugs suspected of prescription cascades from among multiple drugs taken by a single patient; Medication management system.

10. a first determination step of determining whether or not a combination of two or more drugs to be taken by a patient satisfies a first determination condition; a second determination step of determining whether a second determination condition related to the two or more drugs is satisfied; A medication management program for causing one or more processors to execute the above.

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