将配药数据与电子健康医嘱关联：查询商业药房数据库以支持全系统质量改进的教程
Linking Dispense Data to Electronic Health Orders: Tutorial for Querying Commercial Pharmacy Databases to Support Systemwide Quality Improvement.
文献信息
| PMID | 42837533 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Benjamin Michaels |
| 作者单位 | Department of Pharmacy, University of California, San Francisco, 1500 Owens Street, San Francisco, CA, 94158, United States, 1 513 658 0104. |
| 期刊 | Journal of medical Internet research |
| SCI 分区 | Q1 |
| IF | 8.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 评估用药依从性是优质医疗的核心，但将电子健康记录（EHR）中的药物医嘱与门诊药房配药数据关联起来在技术上仍然复杂。
目的： 本研究旨在提供一份通用、可重复的教程，用于将EHR药物医嘱与药房配药数据关联，从而可用于评估药物配药比例。
方法： 我们开发并验证了一种结构化查询方法，利用患者标识符、药物层面标识符、药房标识符和时间约束，将EHR药物医嘱与外部药房配药数据关联。该教程强调关键设计决策，包括处理多个触发事件、跨供应商去重以及管理剂型变化。以2021年1月1日至2024年1月1日期间儿童急性中耳炎就诊的回顾性队列作为示例。
结果： 总体而言，队列中98.3%（302/307）的药房在研究期间至少返回1条配药记录，因此被归类为报告药房。在3404条医嘱中，2616条（76.9%）有记录的配药。
结论： EHR整合的药房数据为评估用药依从性提供了一种可行、及时的替代指标。本教程为关联EHR和药房数据以开展用药依从性研究提供了一个可扩展框架，同时强调了SQL编码的关键方法学考虑。
英文摘要
BACKGROUND: Assessing medication adherence is central to quality care, yet linking electronic health record (EHR) medication orders to outpatient pharmacy dispense data remains technically complex.
OBJECTIVE: This study aimed to present a generalized, reproducible tutorial for linking EHR medication orders to pharmacy dispense data that can be used to assess medication dispense proportions.
METHODS: We developed and validated a structured query approach to link EHR medication orders to external pharmacy dispense data using patient identifiers, medication-level identifiers, pharmacy identifiers, and temporal constraints. The tutorial emphasizes key design decisions, including handling multiple triggering events, deduplication across vendors, and managing formulation changes. A retrospective cohort of pediatric acute otitis media encounters (January 1, 2021, to January 1, 2024) was used as an illustrative example.
RESULTS: Overall, 98.3% (302/307) of pharmacies in the cohort returned at least 1 dispense record during the study period and were therefore classified as reporting pharmacies. Among 3404 orders, 2616 (76.9%) had a recorded dispense.
CONCLUSIONS: EHR-integrated pharmacy data provide a feasible, timely proxy for assessing medication adherence. This tutorial provides a scalable framework for linking EHR and pharmacy data for medication adherence studies, while highlighting key methodological considerations for SQL coding.