[An analysis of the decision process in the pharmacological treatment of a patient with chronic heart failure by means of a therapy management information system: the experience of the Montescano Heart Failure Unit].
A computer-based system integrated into the hospital information system for the pharmacological management of the chronic heart-failure patients admitted to the heart-failure unit of Montescano is presented. The major aims of the system involved monitoring the patients' treatment history and the related therapeutic decision-making. The treatment history of the first 151 consecutive CHF patients admitted after the system implementation is examined. The prescribed drug doses at admission and at discharge are compared, as well as the differences in etiology and NYHA class between patients discharged with or without each drug. Several considerations can be drawn from this analysis. First of all, in heart failure patients the choice of drugs is limited and optimal treatment is a result of individualized dosages. Secondly, time and trials are necessary to obtain optimal treatment. Consequently, continuity of care and in- and out-hospital networks are advisable. Third, a computer-based system offers advantages not only for the pharmacological management itself, but also for improving the quality of care through continuous analysis of the decision-making process.
Opasich
C
C
Divisione di Cardiologia, Policlinico S. Matteo, IRCCS, Pavia.
Pinna
G D
GD
Sisti
M
M
Febo
O
O
Riccardi
P G
PG
Capomolla
S
S
Tangenti
A
A
Perinati
L
L
Cobelli
F
F
Tavazzi
L
L
D016507:Cardiology Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D003199:Computer Systems / Q000706:statistics & numerical data; D003658:Decision Making, Computer-Assisted; D004360:Drug Therapy, Computer-Assisted / Q000379:methods* / Q000706:statistics & numerical data; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D007558:Italy; D008510:Medication Systems, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data; D012984:Software
D002317:Cardiovascular Agents
Analisi del processo decisionale del trattamento farmacologico nel paziente con scompenso cardiaco cronico attraverso un sistema informatizzato di gestione della terapia: esperienza dell'Unità per lo Scompenso Cardiaco di Montescano.