JP7644918B2 - Contraindication determination system, contraindication determination program, contraindication disease name database - Google Patents

Description

The present invention relates to a contraindication determination system and a contraindication determination program capable of determining contraindications for combinations of drugs and disease names, and a contraindicated disease name database used in these.

In hospitals and other medical institutions, prescription data is issued by inputting medical records and prescription details into an electronic medical record system, and medicines are dispensed based on the prescription data. The medicines dispensed based on the prescription data are then used by the patient. There is a known system that can perform a prescription check to automatically determine whether the prescription data is appropriate before dispensing medicines based on the prescription data (see, for example, Patent Document 1).

In particular, the package insert for a drug may list the names of diseases that patients have that make the drug unsuitable for that drug as contraindicated diseases. Therefore, during the prescription check, a contraindicated disease check may be performed to determine whether or not it is appropriate to prescribe the drug to the patient, based on the patient's disease name and the drug's contraindicated disease name.

JP 2013-125377 A

However, even if the contraindicated disease names are of the same type, different expressions may be used if the modifiers for the disease, such as the cause, location, severity, sex, or age, are different. For example, even if the contraindicated disease name is the same type, such as "renal impairment," there may be a drug whose package insert lists the contraindicated disease as "severe renal impairment" and a drug whose package insert lists the contraindicated disease as simply "renal impairment."

However, in systems used in medical institutions, specific codes such as the medical receipt computer code established by the Ministry of Health, Labor and Welfare or standard disease name codes established by medical institutions may be used as identification information to identify disease names. Furthermore, disease names identifiable by the identification information used in the system (hereinafter referred to as "disease names for determination") may be expressed differently from the contraindicated disease names. Specifically, the disease names for determination may not take into account the modifiers of the disease names for determination, and for example, as described above, "severe renal impairment" and "renal impairment", which have different modifiers, may be expressed as the same disease name for determination.

Therefore, the contraindicated disease check does not take modifiers of the contraindicated disease into account, and there is a risk of reducing the accuracy of the judgment of the contraindicated disease. For example, if the contraindicated disease check is set to judge a disease as contraindicated when the patient's disease matches the judgment disease name "renal disorder", then if the patient's disease is "renal disorder", it may be judged as contraindicated for both a drug whose contraindicated disease name is "severe renal disorder" and a drug whose contraindicated disease name is "renal disorder". In this case, a drug that should only be judged as contraindicated when the modifier is "severe" will be judged as contraindicated, resulting in unnecessary confirmation work by the user and other hassle.

The object of the present invention is to provide a contraindication determination system, a contraindication determination program, and a contraindicated disease name database that can improve the accuracy of determining the names of diseases for which medicines are contraindicated.

The contraindication determination system according to the present invention includes a first processing unit capable of executing a first determination process for determining whether or not patient disease name information indicating the name of a patient's disease includes disease name information for determination indicating a disease name for determination that is preset corresponding to a drug prescribed to the patient, and a second processing unit capable of executing a specific process that is preset based on the determination result by the first processing unit, and for combinations of the drug and the disease name information for determination in which the disease name information for determination is the same but the drug is different, the execution or non-execution of the first determination process or the content of the specific process can be changed for each combination.

The contraindication determination system according to the present invention includes a first processing unit capable of executing a second determination process for determining whether or not patient disease name information indicating a disease name of a patient includes a part of the disease name information for determination selected in advance from a plurality of disease name information for determination belonging to one group of the disease name information for determination indicating a disease name for determination preset corresponding to a drug prescribed to the patient, and a second processing unit capable of executing a predetermined specific process based on a determination result by the first processing unit;
and the presence or absence of execution of the second determination process or the content of the specific process can be changed for each combination of the drug and the portion of the disease name information for determination.

The contraindication determination system according to the present invention includes a first processing unit capable of executing a third determination process for determining whether or not the patient disease name information indicating the patient's disease name includes all of the multiple disease name information for determination belonging to one group among the disease name information for determination indicating a disease name for determination preset corresponding to the drug prescribed to the patient, and a second processing unit capable of executing a specific process preset based on the determination result by the first processing unit, and the presence or absence of the third determination process or the content of the specific process can be changed for each combination of the drug and the group.

The contraindication determination program of the present invention is a contraindication determination program for causing a processor to execute a first step of executing a first determination process for determining whether or not patient disease name information indicating the name of a patient's disease contains disease name information for determination indicating a disease name for determination that is preset corresponding to a drug prescribed to the patient, and a second step of being able to execute a specific process that is preset based on the determination result of the first step, and for combinations of the drug and the disease name information for determination in which the disease name information for determination is the same but the drug is different, the execution or non-execution of the first determination process or the content of the specific process can be changed for each combination.

The contraindication determination program of the present invention is a contraindication determination program for causing a processor to execute a first step of executing a second determination process for determining whether or not the patient disease name information indicating the patient's disease includes a portion of the disease name information for determination that is preselected from a plurality of disease name information for determination that belongs to a group of disease name information for determination that indicates a disease name for determination that is predefined corresponding to a drug prescribed to the patient, and a second step of executing a specific process that is predefined based on the determination result of the first step, and the execution or non-execution of the second determination process or the content of the specific process can be changed for each combination of the drug and the portion of the disease name information for determination.

The contraindication determination program of the present invention is a contraindication determination program for causing a processor to execute a first step of executing a third determination process for determining whether or not the patient disease name information indicating the patient's disease name includes all of the multiple disease name information for determination that belong to one group among the disease name information for determination that indicates a disease name for determination that is preset corresponding to the drug prescribed for the patient, and a second step of being able to execute a specific process that is preset based on the determination result of the first step, and whether or not to execute the third determination process or the content of the specific process can be changed for each combination of the drug and the group.

The contraindicated disease name database according to the present invention is a contraindicated disease name database in which a processor executes a judgment process to judge whether or not patient disease name information indicating the name of a patient's disease contains judgment disease name information indicating a judgment disease name that is preset corresponding to a drug prescribed to the patient, and is used when executing a preset specific process based on the judgment result of the judgment process, and for combinations of the drug and the judgment disease name information in which the judgment disease name information is the same but the drug is different, whether or not to execute the judgment process or the content of the specific process can be set for each combination, and the processor can change whether or not to execute the judgment process or the content of the specific process for each combination of the drug and the judgment disease name information based on the contraindicated disease name database.

The present invention provides a contraindication determination system, contraindication determination program, and contraindicated disease name database that can improve the accuracy of determining the names of contraindicated diseases for drugs.

FIG. 1 is a block diagram showing the configuration of a taboo determination system according to an embodiment of the present invention. FIG. 2 is a diagram showing an example of a data structure of a contraindicated disease name master used in the contraindication determination system according to the embodiment of the present invention. FIG. 3 is a flowchart showing an example of a procedure for a contraindicated disease name setting process executed by the contraindication determination system according to the embodiment of the present invention. FIG. 4 is a diagram showing an example of a display screen displayed by the taboo determination system according to the embodiment of the present invention. FIG. 5 is a diagram showing an example of a display screen displayed by the taboo determination system according to the embodiment of the present invention. FIG. 6 is a diagram showing an example of a display screen displayed by the taboo determination system according to the embodiment of the present invention. FIG. 7 is a flowchart showing an example of a procedure for a contraindicated disease name determination process executed by the contraindication determination system according to the embodiment of the present invention. FIG. 8 is a diagram showing an example of a display screen displayed by the taboo determination system according to the embodiment of the present invention. FIG. 9 is a diagram showing an example of a display screen displayed by the taboo determination system according to the embodiment of the present invention. FIG. 10 is a diagram showing an example of a display screen displayed by the taboo determination system according to the embodiment of the present invention. FIG. 11 is a diagram showing an example of a display screen displayed by the taboo determination system according to the embodiment of the present invention.

The following describes an embodiment of the present invention with reference to the attached drawings to facilitate understanding of the present invention. Note that the following embodiment is an example of the present invention and is not intended to limit the technical scope of the present invention.

[Prescription support system 10]
As shown in Fig. 1, a dispensing support system 10 according to an embodiment of the present invention includes a dispensing support device 1, a client terminal 2, a dispensing machine 3, and a printer 4. The dispensing support system 10 is a system used to support dispensing work by pharmacists, and is an example of a contraindication determination system according to the present invention. In this embodiment, users of the dispensing support system 10 are, for example, pharmacists, doctors, nurses, or medical staff.

In the dispensing support system 10, the dispensing support device 1, the client terminal 2, the dispensing equipment 3, and the printer 4 are connected to each other so as to be able to communicate wirelessly or wired via a communication network 5. The communication network 5 may be a LAN, a WAN, the Internet, an intranet, or the like.

The dispensing support device 1 is also connected to a higher-level system 6, such as an electronic medical record system, an ordering system, or a prescription system, via the communication network 5, which inputs prescription data, patient data, and the like to the dispensing support device 1. The dispensing support device 1 may be configured to read out the prescription data, the patient data, and the like from the higher-level system 6. The dispensing support device 1 then transmits dispensing data to the dispensing device 3 for dispensing medicines using the dispensing device 3 based on the prescription data.

The prescription data includes, for example, information such as the patient name, patient ID, prescription ID, prescription issue date, drug identification information (drug code, drug name), dosage, usage, attending physician, medical department, patient disease name information, and hospital ward. The patient data includes, for example, information such as the patient name, patient ID, patient disease name information, gender, age, whether or not the patient drinks alcohol, whether or not the patient smokes, and allergies. The prescription data may include part or all of the patient data. Note that if the prescription data includes information such as the patient disease name information that is part of the patient data, or if the patient disease name information is input by a user operation in the dispensing support system 10, the patient data does not need to be input from the upper system 6 to the dispensing support device 1.

The patient disease name information is an example of identification information for identifying the patient disease name such as an illness or injury that has appeared in a patient, and in the dispensing support system 10, the medical receipt computer code defined by the Ministry of Health, Labor and Welfare and the standard disease name indicated by the medical receipt computer code are used as the patient disease name information. In this embodiment, the "disease name" is not limited to the name of the illness but also includes the name of the injury. In addition, when there are multiple patient disease names corresponding to one patient, the patient disease name information includes information on the multiple patient disease names. In addition, the patient disease name information may be either the medical receipt computer code or the standard disease name. In addition, the patient disease name information is registered in the upper system 6 or the dispensing support system 10 in association with the patient. In addition, in the dispensing support system 10, a standard disease name code defined by a medical institution may be used instead of the medical receipt computer code.

[Pharmacy equipment 3]
Each of the dispensing devices 3 is used in a medical institution such as a hospital or a pharmacy where the dispensing support system 10 is used in dispensing work of medicines. For example, each of the dispensing devices 3 is a tablet packaging machine, a powdered medicine packaging machine, a liquid medicine dispensing machine, a PTP sheet dispensing device, or a co-injection device. For example, the tablet packaging machine has a plurality of medicine cassettes containing a plurality of types of tablets, and performs a packaging operation of dispensing tablets from the medicine cassette and packaging them in packaging paper for each dose according to the dispensing data input from the dispensing support device 1. The powdered medicine packaging machine performs a packaging operation of packaging the input powdered medicine in packaging paper for each dose according to the dispensing data input from the dispensing support device 1. The liquid medicine dispensing machine has a plurality of medicine bottles containing a plurality of types of liquid medicines, and dispenses a required amount of liquid medicine from the medicine bottle according to the dispensing data input from the dispensing support device 1. The PTP sheet dispenser has a plurality of sheet cassettes in which PTP sheets or heat seals in which tablets are prepackaged are stored, and dispenses the PTP sheets or heat seals from the sheet cassettes according to the dispensing data input from the dispensing support device 1. The co-infusion device automatically performs a co-infusion operation of injecting a drug such as an anticancer drug into an infusion liquid using a robot arm according to the dispensing data input from the dispensing support device 1.

[Printer 4]
The printer 4 is a color printer or a monochrome printer that prints information included in print data input from the dispensing support device 1 or the client terminal 2 via the communication network 5 onto a sheet of paper or the like.

[Dispensing support device 1]
The dispensing support device 1 is a personal computer including a control unit 11, a storage unit 12, a communication I/F 13, a display device 14, an operation device 15, and a drive device 16. The dispensing support device 1 may be provided outside a medical institution such as a hospital where the dispensing support system 10 is used. The dispensing support device 1 may be a mobile terminal such as a smartphone or a tablet terminal.

The communication I/F 13 is a communication interface having a network card or the like that performs wireless or wired data communication according to a predetermined communication protocol between the client terminal 2, the dispensing device 3, and external devices such as the printer 4 via the communication network 5.

The display device 14 is a display unit such as a liquid crystal display or an organic EL display that displays various information according to control instructions from the control unit 11. The operation device 15 is an operation unit operated by a user to input various information to the dispensing support device 1. Specifically, the operation device 15 includes a keyboard and a mouse (pointing device) that accept input operations on various operation screens displayed on the display device 14. The operation device 15 may also include a touch panel that accepts touch operations on various operation screens displayed on the display device 14, or a voice input device that accepts input of various information by voice recognition.

The drive device 16 is capable of reading the dispensing assistance program from a computer-readable recording medium 161 on which the dispensing assistance program including the contraindication determination program according to the present invention is recorded. The contraindication determination program is a control program for causing the control unit 11 to execute various processes such as a contraindicated disease name setting process (FIG. 4) and a contraindicated disease name determination process (see FIG. 7) described below. The contraindicated disease name setting process is a process for setting the contraindicated disease name master D11 described below, and the contraindicated disease name determination process is a process for determining whether or not it is appropriate to prescribe a drug to a patient based on the contraindicated disease name master D11 described below.

The recording medium 161 is a CD, DVD, BD, USB memory, or the like, and the drive device 16 is a CD drive, DVD drive, BD drive, USB port, or the like. In the dispensing support device 1, the control unit 11 reads the dispensing support program from the recording medium 161 using the drive device 16 and installs it in the storage unit 12.

The control unit 11 has control devices such as a CPU, a ROM, a RAM, and an EEPROM. The CPU is a processor that executes various arithmetic operations. The ROM is a non-volatile storage unit in which information such as control programs for causing the CPU to execute various processes is stored in advance. The RAM is a volatile storage unit, and the EEPROM is a non-volatile storage unit. The RAM and the EEPROM are used as temporary storage memories (work areas) for the various processes executed by the CPU. The control unit 11 then uses the CPU to execute various processes in accordance with the various control programs stored in advance in the ROM, the EEPROM, or the storage unit 12.

The storage unit 12 is a non-volatile storage unit such as a hard disk or SSD in which various control programs and various data executed by the control unit 11 are stored. Specifically, the storage unit 12 includes a program storage unit 121, an information storage unit 122, and a master storage unit 123.

The program storage unit 121 is a storage area in which the contraindication judgment program is stored. The information storage unit 122 is a storage area in which various information such as the prescription data and the patient data acquired from the upper system 6 is stored. The master storage unit 123 is a storage area in which various master information such as a drug master, a disease name master, a patient master, and a contraindicated disease name master D11 is stored. For example, the drug master includes information such as a drug code (YJ code, etc.), drug name, JAN code, RSS code, medicine bottle code, dosage form, unit, specific gravity, drug type, compounding changes, excipient drug, and precautions for various drugs. The drug master also includes the contents of the package insert for each drug. In addition, the medical receipt computer code and the standard disease name are registered in the disease name master as information for identifying disease names indicating illness or injury.

The patient master is a database in which patient information corresponding to each patient is stored. The patient information includes, for example, the patient name, patient ID, the patient disease name information, gender, age, whether or not the patient drinks alcohol, whether or not the patient smokes, and allergies. The control unit 11 can update the patient master as appropriate based on the prescription data or the patient data acquired from the higher-level system 6. Specifically, the control unit 11 registers the patient disease name information included in the prescription data or the patient data acquired from the higher-level system 6 in the patient master as the patient disease name information corresponding to the patient. The control unit 11 can also edit the patient disease name information in the patient master based on a user operation on the dispensing support device 1 or the client terminal 2.

The contraindicated disease name master D11 is an example of a contraindicated disease name database used to determine whether or not the prescription of a drug to a patient is appropriate based on the name of the disease (disease name) of an illness or injury that has appeared in the patient for whom the drug is prescribed. The control unit 11 can also edit the contraindicated disease name master D11 based on a user operation on the dispensing support device 1 or the client terminal 2. Here, FIG. 2 is a diagram showing an example of the contraindicated disease name master D11.

2, in the contraindicated disease name master D11, a setting attribute indicating an attribute corresponding to the contents that can be set as a judgment method described later, drug identification information for identifying the drug, and judgment disease name information indicating a judgment disease name that is set in advance as information for judging the contraindication of the drug are stored in association with each other. The judgment disease name is used as information for judging the contraindication of a combination of a drug and a disease name in the dispensing support system 10, and may have a different name from the contraindicated disease name described in the package insert. In this embodiment, the judgment disease name information includes the medical receipt computer code and the standard disease name. That is, in this embodiment, the standard disease name is used as the judgment disease name. The judgment disease name information may be either the medical receipt computer code or the standard disease name as long as it is information that can identify the judgment disease name, and may be either the medical receipt computer code or the standard disease name. For example, the judgment disease name information is registered based on the contraindicated disease name described in the package insert of each of the drugs when the contraindicated disease name master D11 is created or updated. In addition, in FIG. 2, an example is given in which data is classified for each of the set attributes in the contraindicated disease name master D11, but the contraindicated disease name master D11 may have a data structure in which data with different set attributes are mixed. Also, the set attribute item may be omitted, and the contraindicated disease name master D11 corresponding to each set attribute may be stored separately.

In addition, in the contraindicated disease name master D11, a check target flag, a check level, and a check group are stored in association with each combination of the drug identification information and the disease name information for judgment as setting information for determining the judgment method in the contraindicated disease name judgment process. That is, in the contraindicated disease name master D11, the setting information corresponding to the combination of the drug and the disease name for judgment is registered for each drug indicated by the drug identification information.

The disease name information for determination may include information that integrates information on a plurality of contraindicated disease names that are the same type of disease name but have different modifiers for the disease name. Specifically, the modifiers include information indicating the degree of the disease such as "severe" and "progressive", information indicating the cause such as "allergic", "bacterial", and "genetic", information indicating the part of the body such as "ankle" and "face", information indicating the age of the patient such as "juvenile", "adolescent", and "senile", information indicating the sex of the patient such as "female" and "male". For example, as shown in FIG. 2, "renal disorder" may be listed as a contraindicated disease name on the package insert of "Drug M1", and "severe renal disorder" may be listed as a contraindicated disease name on the package insert of "Drug M2", but the disease names for determination that correspond to these contraindicated disease names may be integrated into "renal disorder". In FIG. 2, the contraindicated disease name master D11 is described with reference to an example of the original text of the contraindicated disease name for the drug, which is written on the drug's package insert, but the information on the original text of the contraindicated disease name may or may not be included in the contraindicated disease name master D11. Also, here, an example is given in which the disease name for determination corresponding to "severe renal impairment" and "renal impairment" is set to the same name as "renal impairment", which is the disease name excluding the modifier "severe", but this is not limited to this. For example, the disease name for determination does not have to be the same as the name of the disease name portion excluding the modifier.

The check target flag is information indicating whether or not the first judgment process or the second judgment process is executed in the contraindicated disease name judgment process for the combination of the drug and the disease name information for judgment. The first judgment process is a process for judging whether or not the disease name information for judgment corresponding to the drug is included in the patient disease name information. That is, in the first judgment process, it is judged whether or not the disease name for judgment indicated by the disease name information for judgment matches any of the patient disease names included in the patient disease name information. The second judgment process is a process for judging whether or not a part of the disease name information for judgment selected in advance from a plurality of disease name information for judgment belonging to one group of the disease name information for judgment corresponding to the drug is included in the patient disease name information. That is, in the second judgment process, it is judged whether or not the disease name for judgment indicated by a part of the disease name information for judgment selected in advance from a plurality of disease name information for judgment belonging to the same group matches any of the patient disease names included in the patient disease name information. In this embodiment, the group is a series of contraindicated disease names written on the package insert of the drug, etc. For example, if the contraindicated disease name is "severe respiratory function decline in the acute phase of cerebrovascular disease," the disease names for determination "cerebrovascular disease" and "respiratory failure" are one group, and if the contraindicated disease name is "liver disease accompanied by coagulation disorder," the disease names for determination "coagulation disorder" and "liver disease" are one group. In other words, if multiple contraindicated disease names are simply written on the package insert of the drug, such as "liver disorder" and "renal disorder," any of the multiple contraindicated disease names is not a unit of the group.

The check level is information for distinguishing the contents of the specific processing executed based on the judgment result of the first judgment processing or the second judgment processing in the contraindicated disease name judgment processing. Specifically, in the specific processing, when the check level is set to "high", "Disease name contraindication" is displayed, and when the check level is set to "low", "Disease name caution" is displayed, thereby performing notification processing with different notification levels. For example, "Disease name contraindication" is classified as an "error" that is not acceptable in the dispensing support system 10, and "Disease name caution" is classified as a "caution" that is acceptable by requiring confirmation rather than an "error" in the contraindicated disease name judgment processing. In this embodiment, the check level is two levels, "high" and "low", but in other embodiments, the check level may be three or more levels.

The check group is information used to determine whether or not a third determination process is performed to determine whether or not all of the multiple pieces of disease name information for determination belonging to one group among the disease name information for determination are included in the patient disease name information. That is, in the third determination process, it is determined whether or not all of the disease names for determination indicated by the multiple disease name information for determination belonging to the same group match any of the patient disease names included in the patient disease name information. In addition, whether or not the third determination process is performed is determined based not only on the check group but also on the check target flag. Specifically, in the contraindicated disease name determination process, when the check group is a group of multiple disease name information for determination in which the same group identification information is registered and the check target flags of the multiple disease name information for determination are all set to "Yes", the third determination process is performed on the multiple disease name information for determination. In addition, in the contraindicated disease name determination process described later, when the group identification information is not registered in the check group corresponding to the drug, the first determination process or the second determination process is performed as necessary.

In addition, when the third judgment process is executed in the taboo disease name judgment process, the content of the specific process is determined in the specific process based on the check level set corresponding to each of the judgment disease names belonging to the group of the judgment target. Specifically, when the check levels corresponding to each of the judgment disease names belonging to the group of the judgment target are all "high", "Disease name taboo" is displayed as the specific process, and when at least one of the check levels corresponding to each of the judgment disease names belonging to the group of the judgment target is "low", "Disease name caution" is displayed as the specific process. Note that, as another embodiment, when the third judgment process is executed separately from the check level, that is, for the setting attribute C described below in which the check group can be set, a group check level for distinguishing the content of the specific process in the third judgment process may be set. In this case, for example, when the group check level is set to "high", "Disease name taboo" is displayed as the specific process, and when the group check level is set to "low", "Disease name caution" is displayed as the specific process. In another embodiment, when the third judgment process is executed, "Disease name contraindication" may be displayed in the specific process regardless of the check level.

The set attribute is an attribute that is set in advance to distinguish the contents that can be set as the judgment method in the contraindicated disease name judgment process (see FIG. 7). Specifically, in this embodiment, an example will be described in which one of three set attributes A, B, or C is set as the set attribute corresponding to the combination of the drug and the judgment disease name information.

The setting attribute A is an attribute that allows the setting of whether or not to execute the first determination process in the contraindicated disease name determination process and the setting of the content of the specific process in the contraindicated disease name determination process for each combination of the drug and the disease name information for determination. In particular, for combinations of the drug and the disease name information for determination in which the disease name information for determination is the same but the drug is different, the execution of the first determination process or the content of the specific process can be changed for each combination. For example, as shown in FIG. 2, among the drugs belonging to the setting attribute A, for "Drug M1" whose contraindicated disease name described in the package insert or the like is "renal disorder" and "Drug M4" whose contraindicated disease name described in the package insert or the like is "progressive renal disorder" including the modifier "progressive", the check target flag can be set to "Yes" for the former combination of "Drug M1" and "renal disorder", and the check target flag can be set to "No" for the latter combination of "Drug M4" and "renal disorder". Also, as shown in FIG. 2, among the drugs belonging to the setting attribute A, for "Drug M1" whose contraindicated disease name written on the package insert or the like is "renal impairment" and "Drug M2" whose contraindicated disease name written on the package insert or the like is "severe renal impairment" including the modifier "severe", it is possible to set the check level to "high" for the combination of the former "Drug M1" and "renal impairment" and to set the check level to "low" for the latter combination of "Drug M2" and "renal impairment".

The setting attribute B is an attribute that allows the setting of whether or not to execute the second judgment process in the contraindicated disease name judgment process and the setting of the content of the specific process in the contraindicated disease name judgment process for each combination of the drug and a part of the judgment disease name information selected in advance from the multiple judgment disease name information belonging to one group among the judgment disease name information corresponding to the drug. Note that in this embodiment, a case will be described in which the second judgment process can be executed only for one of the judgment disease name information selected in advance from the multiple judgment disease name information belonging to one group among the judgment disease name information corresponding to the drug, but the second judgment process may be executed for each of the judgment disease name information. Specifically, it may be possible to set the check target flag to "Yes" for multiple judgment disease name information belonging to one group among the judgment disease name information corresponding to the drug.

For example, as shown in FIG. 2, among the drugs belonging to the setting attribute B, when there is a "drug M11" whose contraindicated disease name described in the package insert, etc. is "acute cerebrovascular disease" and "severe respiratory function decline", one group of the disease name information for judgment corresponding to the drug includes "acute cerebrovascular disease" and "severe respiratory function decline". The contraindicated disease name "acute cerebrovascular disease" is classified as "cerebrovascular disease" in the disease name for judgment, and the contraindicated disease name "severe respiratory function decline" is classified as "respiratory failure" in the disease name for judgment. In this case, in the contraindicated disease name master D11, the check target flag can be set to "absent" for the combination of "drug M11" and "cerebrovascular disease", and the check target flag can be set to "present" for the combination of "drug M11" and "respiratory failure". Also, as shown in FIG. 2, in the contraindicated disease name master D11, the check level can be set to "high" or "low" for each combination of the disease name information for judgment and the drug. In addition, the check level may be set to "high" or "low" only for combinations of the disease name information for determination and the drug for which the check target flag is set to "yes."

The setting attribute C is an attribute that allows the setting of whether or not to execute the third judgment process in the contraindicated disease name judgment process and the setting of the content of the specific process in the contraindicated disease name judgment process for each combination of the drug and the group. For example, in the example shown in FIG. 2, group identification information is set for each combination of the drug and the group that belongs to the setting attribute C. On the other hand, if there are "Drug M21" whose contraindicated disease name described in the package insert or the like is "liver disease accompanied by coagulation disorder" and "Drug M23" whose contraindicated disease name described in the package insert or the like is "Disease I4 accompanied by disease I3" among the drugs that belong to the setting attribute C, it is possible to set group identification information to the check group for the combination of the former "Drug M21" and a group including "blood coagulation disorder" and "liver disease", and not set group identification information to the check group for the combination of "Drug M23" and a group including "Disease I3" and "Disease I4".

As shown in FIG. 2, for "Drug M22" which is a drug belonging to the setting attribute C and has a contraindicated disease name "Disease I2 accompanied by Disease I1" written on the package insert, etc., it is also possible to set group identification information to the check group and set the check target flags corresponding to each of "Disease I1" and "Disease I2" to "No". When the group identification information is set to the check group, the check target flag may be automatically set to "Yes". Furthermore, as shown in FIG. 2, in the setting attribute C, the check level can be set to "High" or "Low" for each combination of the disease name information for determination and the drug. The check level may be set to "High" or "Low" only for the combination of the drug and the disease name information for determination for which the group identification information is set to the check group.

Meanwhile, in the dispensing support system 10, a specific code such as a computer code defined by the Ministry of Health, Labor and Welfare or a standard disease name code defined by a medical institution may be used as identification information for identifying a disease name. The disease name for determination that can be identified by the identification information used in the dispensing support system 10 may be expressed differently from the contraindicated disease name. Specifically, the disease name for determination may not take into account modifiers such as the cause, site, degree, sex, or age of the disease name, and for example, as described above, "severe renal impairment" and "renal impairment", which have different modifiers, may be expressed by the same disease name for determination. Therefore, in the contraindicated disease name determination process, the modifiers of the contraindicated disease name are not taken into account, and there is a risk that the accuracy of determining the contraindicated disease name will decrease. For example, if the contraindicated disease name determination process is set to determine that a drug is contraindicated when the patient's disease name matches the disease name for determination "renal disorder," then if the patient's disease name is "renal disorder," the drug may be determined to be contraindicated for both the drug whose contraindicated disease name is "severe renal disorder" and the drug whose contraindicated disease name is "renal disorder." In this case, even a drug that should be determined to be contraindicated only when the modifier is "severe" will be determined to be contraindicated, resulting in unnecessary confirmation work by the user and other hassle. In response to this, as described below, the dispensing support system 10 according to this embodiment makes it possible to increase the accuracy of determining the contraindicated disease name of a drug.

Specifically, the control unit 11 of the dispensing support device 1 includes various processing units such as a first processing unit 111, a second processing unit 112, a first setting processing unit 113, a second setting processing unit 114, and a third setting processing unit 115. Specifically, the control unit 11 functions as the various processing units by executing various processes according to the contraindication determination program. In addition, any one or more of the various processing units may be an electronic circuit such as an ASIC or DSP.

The first processing unit 111 can execute the first determination process to determine whether the patient disease name information indicating the patient's disease name (patient disease name) includes the disease name information for determination indicating a disease name for determination that is preset corresponding to a drug prescribed for the patient. Specifically, the first processing unit 111 determines whether the patient disease name information includes the disease name information for determination based on the patient master or the prescription data and the contraindicated disease name master D11 in the first determination process. However, the first processing unit 111 can change whether or not to execute the first determination process for each combination of the drug and the disease name information for determination in which the disease name information for determination is the same but the drug is different, based on the setting of the check target flag in the contraindicated disease name master D11.

The first processing unit 111 can also execute the second determination process to determine whether or not a part of the disease name information for determination selected in advance from the plurality of disease name information for determination belonging to one group among the disease name information for determination corresponding to the drug is included in the patient disease name information. Specifically, the first processing unit 111 determines whether or not the part of the disease name information for determination is included in the patient disease name information in the second determination process based on the patient master or the prescription data and the contraindicated disease name master D11. However, the first processing unit 111 can change whether or not to execute the second determination process for each combination of the drug and the disease name information for determination based on the setting of the check target flag of the contraindicated disease name master D11. In particular, in this embodiment, the first processing unit 111 can execute the second determination process for only one of the plurality of disease name information for determination belonging to one group.

Furthermore, the first processing unit 111 can also execute a third judgment process to judge whether or not all of the multiple pieces of judgment disease name information belonging to one group among the judgment disease name information corresponding to the drug are included in the patient disease name information. Specifically, in the third judgment process, the first processing unit 111 judges whether or not all of the multiple pieces of judgment disease name information belonging to the group are included in the patient disease name information based on the patient master or the prescription data and the contraindicated disease name master D11. However, the first processing unit 111 can change whether or not to execute the third judgment process for each combination of the drug and the group based on the setting of the check group in the contraindicated disease name master D11.

The second processing unit 112 can execute a preset specific process based on the determination result by the first processing unit 111. Specifically, the specific process is a notification process of the determination result by the first processing unit 111. In addition, the second processing unit 112 can change the notification content when notifying the determination result to either "Disease name contraindicated" or "Disease name caution" based on the check level of the contraindicated disease name master D11. Note that the specific process is not limited to the notification process, and may be, for example, a process of changing whether or not the dispensing operation of the dispensing device 3 is to be performed for the prescription data, or a process of changing whether or not a question inquiry about the prescription data is to be automatically sent to the upper system 6.

The first setting processing unit 113 can set whether or not to execute the first judgment process corresponding to each combination of the drug and the disease name information for judgment and the content of the specific process in response to a user operation. The second setting processing unit 114 can set whether or not to execute the second judgment process corresponding to each combination of the drug and the part of the disease name information for judgment and the content of the specific process in response to a user operation. The third setting processing unit 115 can set whether or not to execute the third judgment process corresponding to each combination of the drug and the group and the content of the specific process in response to a user operation. Note that the first setting processing unit 113, the second setting processing unit 114, or the third setting processing unit 115 may be able to set only one of whether or not to execute the first judgment process, the second judgment process, or the third judgment process and the content of the specific process.

[Client terminal 2]
The client terminal 2 is a personal computer including a control unit 21, a storage unit 22, a communication I/F 23, a display device 24, an operation device 25, and a drive device 26. Each of the client terminals 2 is an operation terminal that is installed in a medical institution where the dispensing support system 10 is used and is operated by a user. The client terminal 2 may be a mobile terminal such as a smartphone or a tablet terminal.

The control unit 21 has control devices such as a CPU, a ROM, a RAM, and an EEPROM. The CPU is a processor that executes various arithmetic operations. The ROM is a non-volatile storage unit in which information such as control programs for causing the CPU to execute various processes is stored in advance. The RAM is a volatile storage unit, and the EEPROM is a non-volatile storage unit. The RAM and the EEPROM are used as temporary storage memories (work areas) for the various processes executed by the CPU. The control unit 21 then uses the CPU to execute various processes in accordance with the various control programs stored in advance in the ROM, the EEPROM, or the storage unit 22.

The storage unit 22 is a non-volatile storage unit such as a hard disk or SSD in which various control programs and various data executed by the control unit 21 are stored. Specifically, the storage unit 22 includes a program storage unit 221 in which control programs such as an operating system (OS) and browser software are stored. The browser software is a control program for accessing the dispensing support device 1 via the communication network 5 to display various operation screens on the display device 24 and for transmitting input operations on the operation screen using the operation device 25 to the dispensing support device 1. For example, when address information such as a URL (Universal Resource Locator) corresponding to the dispensing support device 1 is input at a predetermined position on the operation screen displayed by the browser software, the control unit 21 accesses the dispensing support device 1 based on the address information.

The communication I/F 23 is a communication interface having a network card or the like that performs wireless or wired data communication between the dispensing support device 1, the dispensing equipment 3, and external devices such as the printer 4 via the communication network 5 in accordance with a predetermined communication protocol.

The display device 24 is a display unit such as a liquid crystal display or an organic EL display that displays various information according to control instructions from the control unit 21. The operation device 25 is an operation unit operated by a user to input various information to the client terminal 2. Specifically, the operation device 25 includes a keyboard and a mouse (pointing device) that accept input operations on various operation screens displayed on the display device 24. The operation device 25 may also include a touch panel that accepts touch operations on various operation screens displayed on the display device 24, or a voice input device that accepts input of various information by voice recognition.

The drive device 26 is capable of reading the OS or the browser software from a computer-readable recording medium 261 on which the OS or the browser software is recorded. The recording medium 261 is a CD, DVD, BD, USB memory, etc., and the drive device 26 is a CD drive, DVD drive, BD drive, USB port, etc. In the client terminal 2, the control unit 21 installs the OS or the browser software, etc., read from the recording medium 261 using the drive device 26, into the program storage unit 221 of the storage unit 22.

In this embodiment, a server-client system is configured by the dispensing support device 1 and the client terminal 2, and a case will be described in which the dispensing support device 1 executes processes such as input, display, and printing of various information in response to user operations of the client terminal 2. That is, the client terminal 2 is used as an operation terminal of the dispensing support device 1, and the "display," "operation," and "input" described below are performed using the display device 24 and the operation device 25 of the client terminal 2.

In this embodiment, the dispensing support device 1 alone operates as the contraindication determination system according to the present invention, but the client terminal 2 alone may be regarded as the contraindication determination system according to the present invention. For example, it is conceivable that a part or all of the contraindication determination program is installed in the client terminal 2, and the control unit 21 of the client terminal 2 appropriately acquires necessary information from the dispensing support device 1 and executes the same processing as the dispensing support device 1 described in this embodiment. In addition, the dispensing support device 1 and the client terminal 2 may cooperate to execute the same processing as the dispensing support device 1 described in this embodiment.

[Taboo disease name setting process]
Next, with reference to Fig. 3, a description will be given of a contraindicated disease name setting process executed by the control unit 11 of the dispensing support device 1. For example, the contraindicated disease name setting process is executed by the control unit 11 when an operation for requesting editing of the contraindicated disease name master D11 is performed on the dispensing support device 1 at the client terminal 2.

<Step S10>
In step S10, the control unit 11 accepts a user operation for selecting a drug to be processed in the contraindicated disease name setting process (hereinafter referred to as an edit target drug). For example, the control unit 11 displays a list of drugs registered in the drug master or the contraindicated disease name master D11 on the display device 24 as selection candidates for the edit target drug based on the drug master or the contraindicated disease name master D11, and accepts an operation for selecting the edit target drug from the list.

<Step S11>
In step S11, the control unit 11 accepts a user operation for selecting one or more pieces of the determination disease name information (hereinafter referred to as edit target disease name information) that correspond to the edit target drug selected in step S10 and are to be processed in the contraindicated disease name setting process. For example, the control unit 11 displays a list of the standard disease names or the determination disease name information on the display device 24 as selection candidates for the edit target disease name information based on the disease name master or the contraindicated disease name master D11, and accepts an operation for selecting the edit target disease name information from the list.

In addition, when a combination of multiple disease name information for determination is registered as the disease name information for determination corresponding to the edit target drug based on the contraindicated disease name master D11, the control unit 11 may display a list of the combinations of the multiple disease name information for determination on the display device 24 as selection candidates for the edit target disease name information, and accept an operation for selecting the edit target disease name information from the list. For example, for a combination of multiple disease name information for determination registered as one group in the contraindicated disease name master D11, the control unit 11 may display the edit target disease name information on the display device 24 as selection candidates for the group unit, and accept an operation for selecting the group from the list. In addition, when the selected disease name information for editing is not registered in the contraindicated disease name master D11 but is registered in the disease name master, the control unit 11 adds a record corresponding to the edit target disease name information to the contraindicated disease name master D11 in association with the edit target drug.

<Step S12>
In step S12, the control unit 11 determines, based on the contraindicated disease name master D11, whether or not the set attribute corresponding to the combination of the edit target drug and the edit target disease name information is the set attribute A. If it is determined that the set attribute is the set attribute A (S12: Yes), the process proceeds to step S13, and if it is determined that the set attribute is not the set attribute A (S12: No), the process proceeds to step S14.

<Step S13>
In step S13, the control unit 11 accepts a setting operation of the check target flag and the check level for the combination of the edit target drug and the edit target disease name information. The setting process of step S13 is executed by the first setting processing unit 113 of the control unit 11.

For example, the control unit 11 causes the display device 24 to display the first setting screen P11 shown in FIG. 4. The first setting screen P11 displays information on the "drug name" and "disease name for determination" corresponding to the edited drug and the edited disease name information. The control unit 11 may also display the contraindicated disease name described in the package insert corresponding to the edited drug based on the drug master on the first setting screen P11 and setting screens such as the second setting screen P12 and the third setting screen P13 described below. The control unit 11 can accept setting operations of the check target flag and the check level corresponding to the edited drug and the edited disease name information in response to a user operation using the first setting screen P11. The first setting screen P11 displays a pull-down menu area A11 for changing the check target flag to "Yes" or "No" and a pull-down menu area A12 for changing the check level to "High" or "Low". The control unit 11 then accepts the setting of the check target flag and the check level in response to the operation of the pull-down menu areas A11 and A12. After that, the control unit 11 confirms the setting contents on the first setting screen P11 in response to the operation of the registration key K11 on the first setting screen P11, and reflects the setting contents in the contraindicated disease name master D11.

<Step S14>
In step S14, the control unit 11 determines, based on the contraindicated disease name master D11, whether or not the set attribute corresponding to the combination of the edit target drug and the edit target disease name information is the set attribute B. If it is determined that the set attribute is the set attribute B (S14: Yes), the process proceeds to step S15, and if it is determined that the set attribute is not the set attribute B (S14: No), the process proceeds to step S16.

<Step S15>
In step S15, the control unit 11 accepts a designation operation of the disease name for determination to be determined in the second determination process, and a setting operation of the check target flag and the check level for the combination of the edit target drug and the edit target disease name information. The setting process of step S15 is executed by the second setting processing unit 114 of the control unit 11.

For example, the control unit 11 causes the display device 24 to display the second setting screen P12 shown in FIG. 5. The second setting screen P12 displays information on the "drug name" and "disease name for determination" corresponding to the drug to be edited and a plurality of pieces of disease name information to be edited that belong to a group corresponding to the drug to be edited. Also, the second setting screen P12 displays the pull-down menu areas A11 and A12 in the same manner as the first setting screen P11.

Then, in the second setting screen P12, a radio button area A13 for alternatively selecting a part of the disease name information to be edited from among the plurality of pieces of disease name information to be edited is displayed. The control unit 11 selects a part of the disease name information to be edited in response to a user operation of the radio button area A13. Thereafter, the control unit 11 can accept a setting operation of the check target flag and the check level corresponding to a combination of the drug to be edited and the part of the disease name information to be edited in response to a user operation using the pull-down menu areas A11 and A12 of the second setting screen P12. Thereafter, the control unit 11 confirms the setting contents in the second setting screen P12 in response to an operation of the registration key K11 in the second setting screen P12, and reflects the setting contents in the contraindicated disease name master D11. The control unit 11 sets the check target flag to "none" for the disease name information to be edited that is not selected from among the plurality of disease name information to be edited displayed in the radio button area A13. In addition, the pull-down menu areas A11 and A12 may be displayed for each of the multiple disease names to be edited, as in the third setting screen P12 described below, and the check target flag and the check level may be set for each disease name to be edited.

<Step S16>
In step S16, the control unit 11 determines, based on the contraindicated disease name master D11, whether or not the set attribute corresponding to the combination of the edit target drug and the edit target disease name information is the set attribute C. If it is determined that the set attribute is the set attribute C (S16: Yes), the process proceeds to step S17, and if it is determined that the set attribute is not the set attribute C (S16: No), the contraindicated disease name setting process ends.

<Step S17>
In step S17, the control unit 11 accepts setting operations of the check target flag, the check level, and the check group for the combination of the edit target drug and the edit target disease name information. The setting process of step S17 is executed by the third setting processing unit 115 of the control unit 11.

For example, the control unit 11 causes the display device 24 to display the third setting screen P13 shown in FIG. 6. The third setting screen P13 displays information on "drug name" and "disease name for determination" corresponding to the drug to be edited and a plurality of pieces of disease name information to be edited that belong to a group corresponding to the drug to be edited. The third setting screen P13 also displays the pull-down menu areas A11 and A12 corresponding to each piece of disease name information to be edited. The control unit 11 can then accept setting operations for the check target flag and the check level corresponding to each combination of the drug to be edited and the disease name information to be edited in response to a user operation using the pull-down menu areas A11 and A12 of the third setting screen P13. In another embodiment, the third setting screen P13 may not be able to accept the setting operations of the check target flag and the check level corresponding to each combination of the drug to be edited and the disease name information to be edited, but may be able to accept the setting operations of the check target flag and the check level collectively for multiple combinations of the drug to be edited and the disease name information to be edited.

The third setting screen P13 also displays a pull-down menu area A14 for setting whether or not to consider the co-occurrence of multiple pieces of disease name information to be edited. The control unit 11 then accepts the selection of whether or not to determine the co-occurrence of multiple pieces of disease name information to be edited in response to an operation of the pull-down menu area A14.

Then, the control unit 11 confirms the setting contents on the third setting screen P13 in response to the operation of the registration key K11 on the third setting screen P13, and reflects the setting contents in the contraindicated disease name master D11. In particular, when the presence or absence of the judgment of the co-occurrence of the plurality of pieces of edit target disease name information is set to "Yes" in response to the operation of the pull-down menu area A14 corresponding to the co-occurrence of the plurality of pieces of edit target disease name information, the control unit 11 assigns any of the group identification information to the plurality of pieces of edit target disease name information, and registers the group identification information as information of the "check group" corresponding to each piece of edit target disease name information. The control unit 11 may also accept an input operation of any of the group identification information by the user.

In this way, in the contraindicated disease name setting process, the range that can be set for the judgment method differs depending on the setting attribute corresponding to each combination of the drug and the disease name information for judgment, and for example, the check group cannot be set for a combination of a drug belonging to setting attribute A or setting attribute B and the disease name information for judgment.

[Contraindicated disease name determination process]
Next, referring to FIG. 7, the incompatible disease name determination process executed by the control unit 11 of the dispensing support device 1 will be described. For example, the incompatible disease name determination process is executed by the control unit 11 at any timing, such as when the dispensing support device 1 receives the prescription data, before the dispensing support device 1 transmits a dispensing start instruction for the prescription data to the dispensing device 3, or when a user performs an operation to request execution of the incompatible disease name determination process for the prescription data. Hereinafter, the prescription data that is the target of the incompatible disease name determination process is referred to as target prescription data. Note that the incompatible disease name determination process is executed as part of a prescription check process that determines the suitability of the target prescription data for various check items such as "interactions,""overlap (same efficacy, same drug, same ingredient),""dosage,""mixturechanges," and "incompatible disease name." However, only the incompatible disease name determination process will be described here, and a description of the process of determining the suitability of other check items in the prescription check process will be omitted.

In this embodiment, the patient disease name information is included in at least one of the target prescription data or the patient master, and the control unit 11 can acquire the patient disease name information from the target prescription data or the patient master. When the patient disease name information is included in both the target prescription data and the patient master, the control unit 11 may acquire the patient disease name information from the target prescription data or the patient master, whichever has a more recent update date, or may acquire the patient disease name information included in the target prescription data in preference to the patient master. When the control unit 11 cannot acquire the patient disease name information for the patient of the target prescription data, it may display a display screen for prompting the user to input the patient disease name information, and acquire the patient disease name information according to the user input.

<Step S20>
In step S20, each time step S20 is executed, the control unit 11 selects one by one from the drugs included as prescribed drugs in the target prescription data as the drug to be subjected to the contraindicated disease name determination process (hereinafter referred to as the drug to be determined).

<Step S21>
In step S21, the control unit 11 selects, each time step S21 is executed, in order the disease name information for determination (hereinafter referred to as target disease name information for determination) to be the subject of the contraindicated disease name determination process from one or more of the disease name information for determination registered in association with the drug to be determined in the contraindicated disease name master D11. Note that in this embodiment, a case will be described in which the disease name information for determination is selected first and it is determined whether or not the disease name information for determination is included in the patient disease name information, but the patient disease name information may be selected first and it may be determined whether or not the patient disease name information is included in the disease name information for determination of the drug to be determined.

<Step S22>
In step S22, the control unit 11 judges whether or not the group identification information is set for the check group corresponding to the combination of the judgment target drug and the target judgment disease name information based on the contraindicated disease name master D11. If it is judged that the group identification information is set for the check group (S22: Yes), the process proceeds to step S221, and if it is judged that the group identification information is not set for the check group (S22: No), the process proceeds to step S24.

<Step S221>
In step S221, the control unit 11 judges whether or not the check target flags corresponding to all of the disease name information for determination belonging to the check group are set to “Yes.” If it is judged that all of the check target flags are set to “Yes” (S221: Yes), the process proceeds to step S23, and if it is judged that any of the check target flags are set to “No” (S221: No), the process proceeds to step S29.

<Step S23>
In step S23, the control unit 11 executes the third determination process to determine whether or not the plurality of target determination disease name information belonging to one group in which the same group identification information is set in the check group is all included in the patient disease name information of the patient corresponding to the target prescription data. That is, the control unit 11 determines whether or not all of the determination disease names indicated by the plurality of target determination disease name information belonging to the same group match any of the patient disease names included in the patient disease name information. In this case, the determinations of step S21 and step S29 described below are executed assuming that the other determination disease name information belonging to the same group as the target determination disease name information selected in step S21 has already been selected as the target determination disease name information. The third determination process is an example of the first step according to the present invention, and is executed by the first processing unit 111 of the control unit 11. Here, if it is determined that the plurality of pieces of disease name information for subject determination are all included in the patient disease name information (S23: Yes), the process proceeds to step S26, and if it is determined that the plurality of pieces of disease name information for subject determination are not included in the patient disease name information (S23: No), the process proceeds to step S29. As described above, in this embodiment, the plurality of disease names for determination belonging to the group are first selected, and in the third determination process, it is determined whether the plurality of disease name information for determination are all included in the patient disease name information. On the other hand, as another embodiment, each of the patient disease names included in the patient disease name information may be first selected, and it may be determined whether each of the patient disease names corresponds to any of the disease names for determination, and then in the third determination process, it may be determined whether the patient disease name information includes all of the plurality of disease name information for determination belonging to the group.

<Step S24>
In step S24, the control unit 11 judges whether or not the check target flag corresponding to the combination of the judgment target drug and the target judgment disease name information is set to "Yes" based on the contraindicated disease name master D11. If it is judged that the check target flag is set to "Yes" (S24: Yes), the process proceeds to step S25, and if it is judged that the check target flag is set to "No" (S24: No), the process proceeds to step S29.

<Step S25>
In step S25, the control unit 11 executes a determination process to determine whether the subject determination disease name information is included in the patient disease name information. More specifically, when the subject determination disease name information corresponding to the determination target drug does not belong to a group, the control unit 11 executes a first determination process to determine whether the determination disease name information is included in the patient disease name information. That is, in the first determination process, the control unit 11 determines whether the determination disease name indicated by the determination disease name information matches any of the patient disease names included in the patient disease name information. On the other hand, when the subject determination disease name information corresponding to the determination target drug is part of a plurality of subject determination disease name information belonging to one group, the control unit 11 executes a second determination process to determine whether the part of the subject determination disease name information is included in the patient disease name information. That is, in the second determination process, the control unit 11 determines whether the determination disease name indicated by a part of the determination disease name information selected in advance from the plurality of determination disease name information belonging to the same group matches any of the patient disease names included in the patient disease name information. The first and second determination processes are an example of a first step according to the present invention, and are executed by the first processing unit 111 of the control unit 11. Here, if it is determined that the patient disease name information includes the disease name information for subject determination (S25: Yes), the process proceeds to step S26, and if it is determined that the patient disease name information does not include the disease name information for subject determination (S25: No), the process proceeds to step S29. As described above, in this embodiment, the disease name information for determination is selected first, and in the determination process, it is determined whether or not the disease name information for determination is included in the patient disease name information. However, the patient disease name information may be selected first, and in the determination process, it may be determined whether or not the patient disease name information is included in the disease name information for determination of the drug to be determined.

<Step S26>
In step S26, the control unit 11 judges whether the check level is "high" or not based on the contraindicated disease name master D11. Specifically, when it is judged in the third judgment process in step S23 that the patient disease name information contains all of the plurality of disease name information for subject judgment, it is judged whether the check level corresponding to all of the disease name information for subject judgment is "high". Also, when it is judged in the first judgment process or the second judgment process in step S25 that the patient disease name information contains the disease name information for subject judgment, it is judged whether the check level corresponding to the disease name information for subject judgment is "high". Here, if it is judged that the check level is "high" (S26: Yes), the process proceeds to step S27, and if it is judged that the check level is "low" (S26: No), the process proceeds to step S28. For example, when the third judgment process is executed in step S23, if the check level corresponding to all of the disease name information for subject judgment is ``high'', the process proceeds to step S27, and if the check level corresponding to any of the disease name information for subject judgment is ``low'', the process proceeds to step S28.

<Step S27>
In step S27, the control unit 11 sets a first type of notification information that is set in advance and is to be notified to the patient as the determination result by the first processing unit 111 in step S31 described below. Specifically, the control unit 11 stores information indicating that a "disease taboo" has occurred for the drug to be determined in the storage unit 12 as the first type of notification information. For example, the notification information includes information indicating that the determination result is a disease taboo, the drug to be determined that caused the "disease taboo", the disease name information for determination, the patient disease name information, and the like. Furthermore, the control unit 11 may set the notification information to include a taboo disease name written in the package insert corresponding to the drug to be determined based on the drug master.

<Step S28>
In step S28, the control unit 11 sets the notification information of the second mode, which is set in advance and is to be notified to the patient as the judgment result by the first processing unit 111 in step S31 described later. Specifically, the control unit 11 stores information indicating that a "disease name warning" has occurred for the judgment target drug in the storage unit 12 as the notification information of the second mode. For example, the notification information includes information indicating that the judgment result is a disease name warning, the judgment target drug that caused the "disease name warning", the judgment disease name information, and the patient disease name information. Furthermore, the control unit 11 may set the notification information including a contraindicated disease name written in the package insert corresponding to the judgment target drug based on the drug master. In this way, in steps S26 to S28, the notification information to be notified as the judgment result in step S31 described later is changed based on the check level.

<Step S29>
In step S29, the control unit 11 judges whether or not the processing for all the determination disease name information corresponding to the determination target drug has been completed. Specifically, it is judged whether or not all the determination disease name information corresponding to the determination target drug has been selected as the subject determination disease name information in step S21. If it is judged that the processing for all the determination disease name information has been completed (S29: Yes), the processing proceeds to step S30. On the other hand, if it is judged that the processing for all the determination disease name information has not been completed (S29: No), the processing returns to step S21, the next determination disease name information is selected as the subject determination disease name information, and the processing from step S22 onwards is executed. In addition, as another embodiment, the judgment method for a combination of a set of drugs and the disease name information for judgment in the contraindicated disease name master D11 may be registerable in both the setting attribute B and the setting attribute C, and in this case, the control unit 11 may execute both the third judgment process in step S23 and the second judgment process in step S25.

<Step S30>
In step S30, the control unit 11 judges whether or not the processing for all the prescription drugs included in the target prescription data has been completed. Specifically, it is judged whether or not all the prescription drugs included in the target prescription data have been selected as the judgment target drugs in step S20. If it is judged that the processing for all the prescription drugs has been completed (S30: Yes), the processing proceeds to step S31. On the other hand, if it is judged that the processing for all the prescription drugs has not been completed (S30: No), the processing returns to step S20, the next prescription drug is selected as the judgment target drug, and the processing from step S21 onwards is executed.

<Step S31>
In step S31, the control unit 11 executes a notification process for notifying the user of the determination result by the first processing unit 111. The notification process is an example of a specific process in the present invention. Specifically, the control unit 11 notifies the user of the determination result by displaying it on the display device 24. In particular, the control unit 11 notifies the user of the notification information of the first aspect or the notification information of the second aspect set in step S27 or step S28 as the notification result. That is, the control unit 11 can change the notification content of the determination result according to the combination of the drug and the disease name information for determination. The method of notifying the determination result is not limited to display, and the determination result may be notified to the user by printing it by the printer 4, or the determination result may be notified to the user by transmitting it to a preset mobile terminal or the like.

Here, Figs. 8 to 11 are diagrams showing an example of a notification screen P21 when the judgment result is displayed on the display device 24. The notification screen P21 displays various operation keys for accepting user responses such as "approval," "planned doubt," and "question inquiry" after referring to the judgment result. The notification screen P21 may also display judgment results of other check items included in the prescription check process, but a description thereof will be omitted here. Furthermore, the control unit 11 may display, on the notification screen P21 shown in Figs. 8 to 11, the names of contraindicated diseases written on the package insert corresponding to the judgment target drug, based on the drug master.

The notification screen P21 in FIG. 8 shows the determination result when the first determination process or the second determination process determines that the patient disease name information contains the disease name information for determination, and the check level corresponding to the combination of the drug to be determined and the disease name information for determination is set to "high." In this case, the notification screen P21 displays "Disease Name Contraindication" as the determination result, and displays an error message such as "The patient's disease name matches 'renal disorder,' which is a contraindicated disease name for 'Drug M1.'" to notify that a "Disease Name Contraindication" error has occurred.

The notification screen P21 in FIG. 9 shows the determination result when the first determination process or the second determination process determines that the patient disease name information contains the disease name information for determination, and the check level corresponding to the combination of the drug to be determined and the disease name information for determination is set to "low." In this case, the notification screen P21 displays "Caution: Disease Name" as the determination result, and displays a confirmation message such as "Caution required as the patient disease name may match "Severe Renal Damage," which is a contraindicated disease name for "Drug M2." " to notify that a "Caution: Disease Name" confirmation item has occurred.

In this way, in the dispensing support system 10 according to this embodiment, even if the patient disease name information includes the disease name information for determination, the content of the identification process can be changed for each combination of the disease name information for determination and the drug to be determined. For example, for contraindicated disease names with different modifiers indicating the degree of integration into one disease name information for determination, it is possible to change the content of the identification process based on the correspondence between the contraindicated disease name and the drug, thereby improving the accuracy of the determination of contraindicated disease names. This prevents, for example, disease name contraindications from being unnecessarily notified, and reduces the effort of the user in performing unnecessary confirmation work.

In addition, in the dispensing support system 10 according to this embodiment, it is possible to determine the presence or absence of disease name contraindications or disease name cautions for only some of the disease name information for determination within a group containing a plurality of the disease name information for determination for the drug to be determined, and not to determine the presence or absence of disease name contraindications or disease name cautions for the other disease name information for determination. As a result, compared to a case in which the presence or absence of disease name contraindications or disease name cautions is determined individually for all of the disease name information for determination included in the group, for example, disease name contraindications or disease name cautions are not unnecessarily notified, and the effort of the user in performing unnecessary confirmation work is reduced.

The notification screen P21 in FIG. 10 shows the result of the determination when the third determination process determines that the patient disease name information includes all of the multiple disease name information for determination belonging to one group, and the check level corresponding to all combinations of the drug to be determined and the disease name information for determination is set to "high." In this case, the notification screen P21 displays "Disease Name Contraindication" as the determination result, and displays an error message to notify that a "Disease Name Contraindication" error has occurred, such as "The combination of patient disease names matches the combination of "blood coagulation disorder" and "liver disease," which are contraindicated disease names for "Drug M21."

The notification screen P21 in FIG. 11 shows the result of the determination when the third determination process determines that the patient disease name information includes all of the disease name information for determination belonging to one group, and the check level corresponding to any combination of the drug to be determined and the disease name information for determination is set to "low." In this case, the notification screen P21 displays "Caution: Disease Name" as the result of the determination, and displays a confirmation message such as "Caution: The combination of patient disease names may match the combination of "blood coagulation disorder" and "liver disease," which are contraindicated disease names for "drug M21." Please be careful." to inform the user that a "Caution: Disease Name" confirmation item has occurred.

In this manner, in the dispensing support system 10 according to this embodiment, in the third determination process for determining the presence or absence of disease name contraindications or disease name cautions for the determination target drug on a group basis including a plurality of the disease name information for determination, it is possible to change whether or not to determine the presence or absence of disease name contraindications or disease name cautions on a group basis. As a result, compared to a case where a disease name contraindication or disease name caution is determined when only a portion of the disease name information for determination included in the group is included in the patient disease name information, for example, a disease name contraindication or disease name caution is not unnecessarily notified, and the user's effort in performing unnecessary confirmation work is reduced.

As shown in Figures 8 to 11, on the notification screen P21, the display mode, such as the background color or character color, of the display area of the judgment result may be different depending on whether the judgment result of the contraindicated disease name judgment process is "Disease name contraindicated" or "Disease name caution."

In the meantime, in the contraindicated disease name determination process, if step S23 is not executed or if it is not determined in step S23 that the patient disease name information contains all of the disease name information for determination, and if step S25 is not executed or if it is not determined in step S25 that the patient disease name information contains the disease name information for determination, the control unit 11 may, in step S31, display on the notification screen P21 as a notification result that no disease name contraindication or disease name caution has occurred, or may not notify the determination result (not display the notification screen P21).

In addition, in this embodiment, the configuration in which the judgment method corresponding to each combination of the drug and the judgment target disease name information can be individually set in the contraindicated disease name master D11 has been described as an example. Meanwhile, as another embodiment, in the dispensing support system 10, the contraindicated disease name master D11 and an exception master that defines exceptions to the judgment method may be stored in the storage unit 12, and these masters may be used in the contraindicated disease name judgment process. Specifically, the contraindicated disease name master D11 has the basic judgment method registered in advance for each drug. Meanwhile, the control unit 11 accepts a setting operation of the judgment method that is an exception for any combination of the drug and the judgment target disease name information registered in the contraindicated disease name master D11 in response to a user operation, and registers the content of the judgment method in the exception master. Then, in the contraindicated disease name determination process, the control unit 11 executes the process according to the determination method registered in the exception master for the combination of the drug and the disease name information to be determined that is registered in the exception master, and executes the process according to the determination method registered in the contraindicated disease name master D11 for the combination of the drug and the disease name information to be determined that is not registered in the exception master. This makes it possible, for example, to use the contraindicated disease name master D11 that has been used conventionally while changing whether or not to execute the determination process and the content of the specific process for each combination of the drug and the disease name information to be determined.

In addition, in this embodiment, the dispensing support system 10 used to support dispensing work by pharmacists has been described as an example of the contraindication determination system according to the present invention. Meanwhile, instead of the dispensing support system 10, an electronic medical record system capable of registering a patient's medical record and prescription contents in an electronic medical record in response to a user operation such as a doctor may be the contraindication determination system according to the present invention. In this case, when a user operation is performed to register a medical record or prescription contents corresponding to a patient in the electronic medical record, a control unit such as a computer included in the electronic medical record system executes the contraindicated disease name determination process (FIG. 7) using the prescription data corresponding to the patient as the processing target.

[Another example of taboo judgment processing]
In the contraindicated disease name determination process, the first determination process or the second determination process is executed as necessary when the group identification information is not registered in the check group corresponding to the drug. On the other hand, as another embodiment, in the contraindicated disease name determination process, even if the group identification information is registered in the check group corresponding to the drug, the first determination process or the second determination process may be executed as necessary. Specifically, if it is determined in the step S221 that any of the check target flags is set to "absent" (S221: No), the process may proceed to step S24. Then, if it is determined in the step S24 that the check target flag is set to "present" for the determination disease name information (S24: Yes), a determination process is executed in the step S25 in which it is determined whether the determination disease name information is included in the patient disease name information. In this case, in the step S26, the process is branched based on the check level corresponding to the determination disease name information determined to be included in the patient disease name information (S26: Yes or No). In this case, the other disease name information for determination belonging to the same group as the disease name information for subject determination selected in step S21 is not selected as the disease name information for subject determination, and the determinations in step S21 and step S29 described below are executed. This makes it possible to individually determine whether each of the disease name information for determination is contraindicated as necessary, even if the check group is set.

[Topical medication area determination function]
Incidentally, the drug to be judged as the subject of the contraindicated disease name judgment process may be an external preparation applied or pasted to a specific part of the patient. In this case, the judgment of whether or not there is a disease contraindication or a disease caution may differ depending on the part to which the external preparation is used. For example, consider a case where a disease manifests only in a specific damaged part, such as a "burn of second degree or more deep" on the "hand" of a patient to whom an external preparation is prescribed. In this case, if the disease name information to be judged corresponding to the external preparation is "burn of second degree or more deep", it will be judged as a disease contraindication or a disease caution even if the purpose of use of the external preparation is not the damaged part.

Therefore, for the topical agent, it may be necessary to consider the site of use of the topical agent when determining whether the topical agent is contraindicated or cautioned based on the disease name information for determination. Therefore, for a specific topical agent for which it is sufficient to determine whether the topical agent is contraindicated or cautioned only for a specific site of a drug, the dispensing support system 10 may be provided with a topical agent site determination function that can consider the site of use of the specific topical agent when determining whether the topical agent is contraindicated or cautioned based on the disease name information for determination corresponding to the specific topical agent. Specifically, in the contraindicated disease name master D11, it is possible to set a site confirmation flag for a combination of the specific topical agent and the disease name information for determination. For example, when the disease name information for determination is a disease name such as "cerebral hemorrhage" for which the result of the disease name contraindication or caution is the same depending on the site of use of the topical agent, "0" indicating this is set as the site confirmation flag. On the other hand, if the disease name information for determination is a disease name such as "second-degree deep burn or deeper" or "shingles," for which the disease name contraindication or disease name caution determination results may differ depending on the area where the topical agent is used, a "1" indicating this is set as the area confirmation flag.

In step S26, the control unit 11 may proceed to step 28 if the check level is "high" but the site confirmation flag is "1". In this case, in step S28, the notification information is set so that a message is displayed indicating that the topical agent is contraindicated for a disease depending on the site on the patient where it is used. This makes it possible to not determine that the topical agent is contraindicated for a disease if the intended use of the topical agent is not the damaged site, thereby reducing the user's effort in performing unnecessary confirmation tasks.

In addition, if the damaged area is registered in the patient disease name information registered in the patient master or the prescription data, etc., and the area where the topical agent is to be used is registered in the prescription data, the control unit 11 may determine that the disease is contraindicated if the damaged area and the area where the agent is to be used match based on the patient disease name information and the disease name information for determination, and may not determine that the disease is contraindicated if the damaged area and the area where the agent is to be used do not match.

1: dispensing support device 11: control unit 12: storage unit 13: communication I/F
14: Display device 15: Operation device 16: Drive device 2: Client terminal 21: Control unit 22: Storage unit 23: Communication I/F
24: Display device 25: Operation device 26: Drive device 3: Dispensing device 4: Printer 10: Dispensing support system

Claims (4)

a first processing unit capable of executing a first determination process for determining whether or not the patient disease name information includes disease name information for determination based on patient disease name information indicating the name of the patient's disease and disease name information for determination indicating a disease name for determination preset in correspondence with the site of application of the topical preparation of the patient and the medicine prescribed for the patient;
A second processing unit that executes a predetermined specific process including a notification process based on a result of the determination by the first processing unit;
Equipped with
the first processing unit, in the first determination process, when an injured part of the patient included in the patient disease name information does not match an application part of the topical agent, does not determine that the patient disease name information includes the disease name information for determination.
Contraindication determination system. the first processing unit is capable of switching between the first determination process and a second determination process for determining whether or not the patient disease name information includes the disease name information for determination based on the patient disease name information and the disease name information for determination,
The first processing unit is
executes the first determination process when the combination of the drug and the disease name information for determination is a combination of a predetermined specific topical agent and the disease name information for determination, and executes the second determination process when the combination of the drug and the disease name information for determination is not a combination of the specific topical agent and the disease name information for determination.
The taboo determination system according to claim 1 . The application site of the topical preparation is information registered in prescription data including information on the drug prescribed to the patient.
The taboo determination system according to claim 1 or 2 . To the processor,
a first step capable of executing a first determination process for determining whether or not the patient disease name information includes disease name information for determination based on patient disease name information indicating the name of the patient's disease and disease name information for determination indicating a disease name for determination preset in correspondence with the site of application of the topical preparation of the patient and a drug prescribed for the patient;
a second step of executing a predetermined specific process including a notification process based on a result of the determination in the first step;
A contraindication determination program ,
In the first step, when an injured part of the patient included in the patient disease name information does not match an application part of the topical agent in the first determination process, it is not determined that the patient disease name information includes the disease name information for determination.
Contraindication determination program .