医療情報学オンラインジャーナル

杉山　　　正¹、梅本　　敬夫²、紀ノ定　保臣²、片桐　　義博¹

¹岐阜大学医学部附属病院薬剤部 、²岐阜大学医学部附属病院医療情報部

処方オーダリングシステムの新たな機能として，癌の告知状況を処方箋に印字するシステムを構築した．このシステムでは，医師が抗癌剤を処方すると告知状況を入力するウインドが処方画面に展開する．医師が告知状況を入力すると，その情報が識別記号に変換されて処方箋に印字される．このシステムによって，薬剤師は処方箋から癌告知の有無が確認できる． 　平成 11 年 6 月〜10 月に発行された処方箋を基に癌告知率を調査した．本院の告知率は約 78% であった．癌告知率は診療科間，年齢層間で大きく異なっていた． 　今回の結果から，癌告知は一般的に行われているものの，未告知の患者も多くいることが判った．したがって，薬剤師が患者に対して抗癌剤に関する情報を提供する場合は，癌告知の有無を確認することが必要になる．今回の支援システムによって，病院薬剤部あるいは調剤薬局の薬剤師は抗癌剤に関して癌の告知状況に応じた情報提供が可能になった． We developed a computerized system of the result of truth telling the diagnosis of cancer to pharmacist as a new function of prescription order entry system already in operation. This system works as follows, when a doctor prescribes anticancer agents in order entry system, level of truth telling are displayed as "yet," "already" or "others" for selection. If the level "already" is selected, it means that the patient has already been told the true diagnosis of cancer. The level "yet" means that the patient has not been told yet and the level "others" means anticancer agents are used not for the treatment of cancer. Only when the level "already" is selected, the figure "〇" is printed on prescription sheet as a sign of truth telling. Confirming the sign on prescription sheet, pharmacist is able to know the result of truth telling. The rate of patient told the truth of cancer diagnosis was investigated by analysis of prescription data in out-patients between June and October 1999. The rate of truth telling was 78% of cancer patients in our hospital, but there were significant differences in the rate among clinical departments or age of patients. These results indicate that truth telling the diagnosis of cancer was generally carried out in our hospital, however some patients still remained without it. Therefore, it is very important for pharmacist to confirm the result of truth telling before they provide drug information about anticancer agent to patient. By our new system, pharmacist in our hospital or in community pharmacy now can provide medication instruction more property than ever.