title: Development of clinical application for a nutritional prescription support system for total parenteral/enteral nutrition.
abstract: One of the important roles of pharmacists as members of a nutrition support team is nutritional prescription support. We developed a nutritional prescription support system (NPSS) that facilitates prescription support and analysis and evaluated its usefulness in nutritional therapy. An NPSS for prescription support and the management of patient information was created. With this NPSS, the nutritional status was assessed, and, on the basis of the results, such variables as the total energy expenditure were calculated. This system allows prescription support for parenteral nutrition (PN) therapy, enteral nutrition (EN) therapy, and the transition period between them. This system was used for 2 representative patients and evaluated. In a malnourished patient receiving oral warfarin, EN solutions were compared by means of the NPSS, and an appropriate EN solution was selected. In addition, the prothrombin time-international normalized ratio was monitored, and favorable results were obtained regarding the adjustment of the warfarin dose and nutritional management. In a patient with aspiration pneumonia, continuous nutritional management to EN from PN therapy was straightforwardly performed with the NPSS. This NPSS allows rapid, comprehensive nutritional management during the transition period to EN from PN therapy, despite these therapies being considered separately in conventional nutritional management. The NPSS is useful for simplifying prescription support and facilitating information sharing among members of a nutrition support team.
authors.affiliation: Division of Clinical Pharmacotherapeutics, Programs for Applied Biomedicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan. syusyu.m@d7.dion.ne.jp
authors.forename: Syuzo
authors.initials: S
authors.lastname: Masuda
authors.forename: Ryusho
authors.initials: R
authors.lastname: Oka
authors.forename: Koji
authors.initials: K
authors.lastname: Uwai
authors.forename: Yumi
authors.initials: Y
authors.lastname: Matsuda
authors.forename: Tadashi
authors.initials: T
authors.lastname: Shiraishi
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Tohru
authors.initials: T
authors.lastname: Shoji
authors.forename: Chie
authors.initials: C
authors.lastname: Mihara
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Takeshita
authors.forename: Koichiro
authors.initials: K
authors.lastname: Ozawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D008297:Male; D015596:Nutrition Assessment; D010289:Parenteral Nutrition, Total; D010346:Patient Care Management; D010348:Patient Care Team; D055656:Prescriptions