Analysis Of Prescription Drug-related Problems And Construction Of Universal Medication Schedule Database For Patients With Chronic Obstructive Pulmonary Disease In Outpatient Clinic

Objectives:A retrospective analysis of the occurrence and causes of drug-related problems（DRPs）in outpatients with chronic obstructive pulmonary disease（COPD）was conducted to explore the factors that influencing the occurrence of DRPs.To construct a universal medication schedule（UMS）database to provide a solid data base for personalized medication education and medication reminders for COPD patients.Methods:DRPs in prescriptions of outpatients with COPD from September2020 to November 2021 were analyzed,using the Pharmaceutical Care Network Europe（PCNE）classification system.Patients were divided into DRPs and non-DRPs groups based on the occurrence of DRPs in their prescriptions,which in turn led to univariate analysis of patient demographic and clinical outcome data,as well as the use of binary logistic regression to explore the factors associated with the occurrence of DRPs affecting outpatients with COPD.We confirm the drug catalogs related to the treatment of COPD patients in hospitals,and build a database for medication reminder scheduling and medication education tips by extracting the data related to drug instructions and evidence-based medicine from the catalogs and editing the data twice by a team of professional physicians and clinical pharmacists combined with the pharmacological characteristics of drugs at the time.Results:A total of 461 patient prescriptions were included,and 239 prescr iptions with DRPs were identified,with an incidence of 51.8%（239/461）.Prob lems with treatment effectiveness accounted for 218（91.2%）,and poor treatme nt outcomes reached 125（27.1%）.The reasons for the occurrence of DRPs we re that patients did not have or did not have proper efficacy monitoring 157（34.1%）,followed by patients taking insufficient doses or not taking the medic ation at all accounting for 66（14.3%）.The DRPs groups and non-DRPs group s were 239 and 222,respectively.Binary logistic results showed that age（P=0.023,OR=1.033,95%CI=1.004-1.062）,uncombined silicosis（P=0.022,OR=0.056,95%CI=0.005-0.662）,acute exacerbation history（P=0.024,OR=1.324,95%CI=1.037-1.690）,uncombined bronchiectasis（P=0.006,OR=0.352,95%CI=0.166-0.746）,treatment without long-actingβ₂ receptor agonists（LABA）+long-ac ting muscarinic antagonists（LAMA）combination（P=0.001,OR=0.359,95%CI=0.191-0.674）,not using antibiotics（P=0.001,OR=0.162,95%CI=0.056-0.470）,and not actively smoking（P=0.001,OR=0.347,95%CI=0.182-0.663）.1135 dr ugs were available in the UMS database mainly.The total number of drug int eraction data was 496708.And 1674 drug and ingredient associations were ide ntified.The database can be accessed through a web link（http://182.61.35.239:5010/login?next=%2Ft＿medicine＿basic＿info）.Conclusions:The incidence of DRPs in outpatients with COPD was 51.8%,and the main DRPs were poor treatment outcomes.The older the patient,the combination of bronchiectasis and silicosis,the use of antibiotics,the therapeutic use of LABA+LAMA,active smoking,and the history of acute exacerbation,the more likely will occur DRPs.The UMS database provides data support for the future development of an application system that intelligently generates a clear UMS for accurate medication reminders,and automatic identification and monitoring of drug interactions as a function.