title: [The improvement of the enforcement rate of the standard regimen (A) of tuberculosis chemotherapy by the introduction of common database system for tuberculosis].
abstract: OBJECTIVE
  The purpose of this study was to improve the enforcement rate of the standard regimen (A) of tuberculosis chemotherapy. SUBJECTIVE AND METHODS: We introduced the common database system for tuberculosis in three national hospitals in Hokkaido. From January 2002 to December 2003, we collected the anonymous informations of the patients with tuberculosis at the start of treatment, at the discharge and at the end of treatment. Then, we reported the enforcement rate of the standard regimen (A) as a clinical indicator periodically to three hospitals.
  
  
  RESULTS
  Four hundred and twenty-nine patients were registered. In patients below 80 years old, the enforcement rate of the standard regimen (A) was 48.5% in 2002. The enforcement rate rose significantly to 62.7% (p = 0.0126) in 2003. In elder smear-positive patients (> or =75) and in elder smear-negative patients (> or =70), the enforcement rate was low (29.1% and 25.0%, respectively). Furthermore in young smear-negative patients (< or =29), the enforcement rate was low (28.0%). As the extent of their disease was minimal, they were treated with other regimens. In patients treated with the standard regimen (A), there were no significant differences in the frequency of adverse effects between elder patients ( 70) and other patients (< or =69). There were also no significant differences in the frequency of changing the regimen between them. Median admission period of 2002 was 114 days. In 2003, it was shortened significantly to 110 days (p = 0.0487).
  
  
  CONCLUSIONS
  By the introduction of the common database system for tuberculosis, the enforcement rate of the standard regimen (A) was improved. Low enforcement rate in young smear-negative patients in an important problem to be improved in the future. The clinical indicator based on the common database system between hospitals, is useful to clarify the problems, and then to improve the quality of medical performance.
authors.affiliation: Department of Respiratory Medicine, NHO Dohoku National Hospital, 7 Hanasaki, Asahikawa-shi, Hokkaido 070-8644, Japan. fujikane@douhoku.hosp.go.jp
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Fujikane
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Yamazaki
authors.forename: Satoru
authors.initials: S
authors.lastname: Fujiuchi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Akinori
authors.initials: A
authors.lastname: Takeda
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nishigaki
authors.forename: Yuka
authors.initials: Y
authors.lastname: Fujita
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Shimizu
authors.forename: Arisu
authors.initials: A
authors.lastname: Kamada
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Araya
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000995:Antitubercular Agents / Q000008:administration & dosage*; D019992:Databases as Topic; D006751:Hospital Information Systems; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D014376:Tuberculosis / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents