Krovni pregled raziskav sistemov za podporo kliničnemu odločanju o zdravljenju z zdravili

Klobučar, Lovro (author), Kos, Mitja (mentor)

Ozadje: Zdravljenje z zdravili je določenim osebam že dnevna rutina. Razvoj tega področja je prišel tako daleč, da se povprečna življenjska starost stalo viša. Vendar pa je razvoj pripeljal do vse več novih zdravil in z njimi več napak predpisovalcev. V namen izogibu napak in enostavnejšemu pristopu dela so se začeli razvijati različni računalniški sistemi, ki pri tem pomagajo. Eden od njih so tudi sistemi za pomoč kliničnemu odločanju (CDSS). Namen: Ugotoviti učinkovitost in opcije za nadaljnjo raziskovanje in razvoj sistemov za podporo kliničnemu odločanju na podlagi izdelave krovnega pregleda sistematičnih pregledov in meta-analiz raziskav sistemov, ki se uporabljajo pri kliničnemu odločanju o zdravljenju z zdravili. Metode: V podatkovni bazi MEDLINE (PubMed) smo z definiranim iskalnim profilom poiskali vse sistematične preglede objavljene do maja 2022. Naredili pregled literature ter izbrane sistematične preglede in meta-analize ovrednotili po smernicah vprašalnika PRISMA. Pripravili smo vsebinski povzetek ter interpretacijo vseh vključenih sistematičnih pregledov. Rezultati: V krovni pregled smo vključili 31 sistematičnih pregledov in meta-analiz. Povprečna ocena v študijah z vprašalnikom PRISMA je bila 77%. Čeprav so se članki po kakovosti razlikovali, so se učinkovite intervencije med višje in nižje kakovostnimi študijami ujemale. Pri preučevanju vpliva CDSS-jev smo ugotovili, da sistemi dobro pomagajo zdravstvenemu osebju pri procesu oskrbe bolnikov. Rezultati v skupini, ki je opisovala CDSS-je na izid bolnika, so bili nekoliko slabši. Ugotovili smo tudi, da CDSS-ji specializirani za določeno bolezensko stanje, kažejo pozitivne rezultate v obeh skupinah. Sklep: Učinkovitost CDSS-jev se pri posamezni skupni razlikuje. A kljub temu lahko rečemo, da CDSS-ji pozitivno vplivajo na zdravstveno osebje in bolnike. še posebej, če so osredotočeni na specifično bolezensko stanje. V prihodnosti so potrebne nadaljnje raziskave vpliva CDSS-ja na izid bolnika in razvoj modernejših, osebju prijaznejših in bolj podrobno dodelanih CDSS-jev.

• Language: Slovenian
• Keywords: sistemi za pomoč kliničnemu odločanju, CDSS, zdravljenje z zdravili
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2023
• PID: 20.500.12556/RUL-144359
• Publication date in RUL: 16.02.2023

Secondary language

• Language: English
• Title: An umbrella review of research on systems that support pharmacotherapy-related clinical decision-making

Abstract

Background: For some people, medication is already a daily routine. The development of this field has gone so far that the average life expectancy is rising. However, developments have led to more and more new medicines and with them more prescribing errors. To avoid errors and to make the work process easier, various computerized systems have been developed to help in this process. One of them is clinical decision support systems (CDSS). Purpose: To identify the effectiveness and options for further research and development of clinical decision support systems by producing an umbrella review of systematic reviews and meta-analyses of research on systems used in clinical decision making to pharmacotherapy. Methods: We searched the MEDLINE database (PubMed) with a defined search profile for all systematic reviews published up to May 2022. We performed a literature search and evaluated the selected systematic reviews and meta-analyses according to the guidelines of the PRISMA checklist. We prepared a content summary and interpretation of all included systematic reviews. Results: 31 systematic reviews and meta-analyses were included in the umbrella review. The average score in the PRISMA studies was 77 %. Although the articles varied in quality, the effective interventions were consistent between higher- and lower-quality studies. When examining the impact of CDSSs, we found that the systems work well to assist healthcare staff in the patient care process. The results in the group describing CDSSs on patient outcomes were slightly worse. We also found that CDSSs specialized in a particular disease state showed positive results in both groups. Conclusion: The effectiveness of CDSSs varies from one group to another, but it can be said that CDSSs have a positive impact on healthcare staff and patients, especially if they are focused on a specific disease state. Further research on the impact of CDSS on patient outcomes and the development of more modern, staff-friendly, and detailed CDSSs are needed in the future.

• Keywords: clinical decision support systems, CDSS, drug therapy, pharmacotherapy