人工智能在医院药学服务中的应用与发展
Application and Development of Artificial Intelligence in Hospital Pharmacy Services
DOI: 10.12677/ACM.2023.1381758, PDF,    国家科技经费支持
作者: 周晓倩, 杨富蓉, 杨松烨, 翁稚颖*:昆明医科大学药学院暨云南省天然药物药理重点实验室,云南 昆明;钱懿轶, 陈韦兆:云南省阜外心血管病医院药剂科,云南 昆明
关键词: AI药学服务处方前置审核慢病管理个体化用药AI Pharmacy Services Pre-Prescription Review Chronic Disease Management Individualized Med-icine
摘要: 随着国家各项鼓励医疗人工智能(AI)政策的陆续出台,人工智能在医疗领域飞速发展,切实带动了多个方面的进步。在医院药学服务中,人工智能虽然起步较晚,但也充分展示出其发展的优势和潜力。处方前置审核、慢病管理、个体化用药是医院药学服务的重要内容,通过对人工智能在上述三方面工作中的应用和研究进展进行综述,同时展望其发展趋势,提出建议,以期为促进人工智能在医院药学服务中的发展提供更多的参考。其中包括对HIS系统中嵌入人工智能的处方前置审核系统、研发各类“互联网+”人工智能慢病管理平台、机器学习剂量预测模型和智能应用程序(APP)的联合应用等具体实现形式的分析和概括,提出基层医院的经费和设备与大型医院的差距、患者接受程度以及很多方面的发展停留在研发阶段可能是目前人工智能在医院药学服务方面发展的最大局限和亟待解决的问题。
Abstract: With the successive introduction of various national policies to encourage medical artificial intelli-gence (AI), artificial intelligence has developed rapidly in the medical field, effectively driving pro-gress in many aspects. In hospital pharmacy services, although artificial intelligence started late, it also fully demonstrated the advantages and potential of its development. Pre-prescription review, chronic disease management, and individualized medication are important contents of hospital pharmacy services, and by reviewing the application and research progress of artificial intelligence in the above three aspects, and looking forward to its development trend, suggestions are made in order to provide more references for promoting the development of artificial intelligence in hospital pharmacy services, including the analysis and summary of specific implementation forms such as the pre-prescription review system embedded in artificial intelligence in the HIS system, the re-search and development of various “Internet+” artificial intelligence chronic disease management platforms, the joint application of machine learning dose prediction models and intelligent applica-tions (APP), etc. It is proposed that the gap between the funds and equipment of grassroots hospi-tals and large hospitals, the degree of patient acceptance and the development of many aspects staying in the research and development stage may be the biggest limitation and urgent need to be solved in the current development of artificial intelligence in hospital pharmacy services.
文章引用:周晓倩, 钱懿轶, 杨富蓉, 杨松烨, 陈韦兆, 翁稚颖. 人工智能在医院药学服务中的应用与发展[J]. 临床医学进展, 2023, 13(8): 12536-12541. https://doi.org/10.12677/ACM.2023.1381758

参考文献

[1] Lawrence, D.R., Palacios-González, C. and Harris, J. (2016) Artificial Intelligence. Cambridge Quarterly of Healthcare Ethics, 25, 250-261. [Google Scholar] [CrossRef
[2] 满靖怡. 浅谈人工智能在药学领域的应用[J]. 产业创新研究, 2020(18): 113-114.
[3] 易思敏, 陈敏. 基于知识图谱的智能医学影像辅助诊断系统研究现状分析[J]. 中国数字医学, 2020, 15(8): 57-59.
[4] 刘洪臣. 人工智能口腔医学[J]. 中华口腔医学杂志, 2020, 55(12): 915-919.
[5] 蔡耀婷, 宋锦平. 人工智能技术在新型冠状病毒肺炎疫情防控工作中的应用及启示[J]. 护理研究, 2020, 34(7): 1117-1118.
[6] 张戎, 刘洪臣. 人工智能技术在临床医疗中的应用概述[J]. 中华老年口腔医学杂志, 2021, 19(1): 40-44.
[7] 于观贞, 刘西洋, 张彦春, 等. 人工智能在临床医学中的应用与思考[J]. 第二军医大学学报, 2018, 39(4): 358-365.
[8] 宋晓丹. 数字化药房的建设与持续优化改进[J]. 中国现代医药杂志, 2022, 24(6): 83-86.
[9] 周歧骥, 廖英勤, 黄祖良. 临床药学国内外发展现状及发展建议[J]. 临床合理用药杂志2022, 15(4): 178-181.
[10] 关于印发医疗机构处方审核规范的通知[J]. 中华人民共和国国家卫生健康委员会公报, 2018(6): 31-34.
[11] 徐晖, 黄水金, 姜洪满. 基于人工智能的门诊处方前置审核模式的实践与评价[J]. 海峡药学, 2022, 34(1): 144-147.
[12] 沈峻, 鲁威. 基于人工智能的区域处方前置审核系统建设与应用[J]. 中国卫生信息管理杂志, 2019, 16(4): 493-496.
[13] 武明芬, 史卫忠, 赵志刚. 国内处方前置审核系统的比较[J]. 中南药学, 2019, 17(9): 1547-1552.
[14] 洪顺福, 陈双双, 卢丽珠, 等. 开展处方前置审核的分析与思考[J]. 中医药管理杂志, 2019, 27(18): 216-218.
[15] 李汶睿, 李頔, 赵春景, 等. 我国医疗机构处方前置审核开展的现状分析[J]. 中国药房, 2021, 32(5): 524-529.
[16] 姚华星, 赵一丹, 连正辉, 等. 信息化手段控制处方剂量在合理用药中的作用[J]. 海峡药学, 2019, 31(4): 289-291.
[17] 徐锦秀. 实行处方前置审核促进药物合理应用研究[J]. 智慧健康, 2022, 8(11): 114-116.
[18] 中共中央 国务院印发《“健康中国2030”规划纲要》[J]. 中华人民共和国国务院公报, 2016(32): 5-20.
[19] 国务院办公厅关于印发中国防治慢性病中长期规划(2017-2025年)的通知[J]. 中华人民共和国国务院公报, 2017(7): 17-24.
[20] 张玉罗, 陈文俊, 陈晨, 等. “互联网+”人工智能模式在慢病管理中的应用研究[J]. 高考, 2018(25): 211-234.
[21] 那孝花. “互联网+”慢性病管理模式在2型糖尿病患者中的应用[J]. 人人健康, 2020(14): 393.
[22] 王力, 陈康, 魏文志, 等. 互联网+全程慢病管理模式对高血压慢病的疗效研究[J]. 河北医药, 2018, 40(12): 1803-1806.
[23] 李哲明, 俞刚. 基于人工智能技术的儿童慢病管理平台的研制与应用[J]. 中国医疗设备, 2020, 35(S2): 172-174.
[24] 许伟岚, 齐金玲, 李喜春, 等. 人工智能辅助系统对老年慢性病患者居家风险管理的作用[J]. 齐齐哈尔医学院学报, 2021, 42(11): 974-976.
[25] 徐楚鸿, 艾又生, 陈华庭. 人工神经网络法预测肾移植术后患者环孢素A的血药浓度[J]. 中国医院药学杂志, 2008(4): 276-278.
[26] 宋学武, 高慧儿, 张弋. 基于人工智能的机器学习算法在个体化用药领域的应用进展[J]. 中国新药与临床杂志, 2021, 40(10): 683-688.
[27] Cao, H., Jiang, S.J., Lv, M., et al. (2021) Effectiveness of the Alfalfa App in Warfarin Therapy Man-agement for Patients Undergoing Venous Thrombosis Prevention and Treatment: Cohort Study. JMIR mHealth and uHealth, 9, e23332. [Google Scholar] [CrossRef] [PubMed]
[28] Jiang, S.J., Lv, M., Wu, T.T., et al. (2022) A Smartphone Application for Re-mote Adjustment of Warfarin Dose: Development and Usability Study. Applied Nursing Research, 63, Article ID: 151521. [Google Scholar] [CrossRef] [PubMed]
[29] 张永春, 李海琳, 李业涛, 等. 人工智能辅助华法林抗凝自我管理系统可靠性评价的前瞻性队列研究[J]. 中国胸心血管外科临床杂志, 2021, 28(5): 504-509.
[30] 沈爱宗, 刘琳琳, 赵景鹤, 等. 抗菌药物合理使用预警系统及成效分析[J]. 中国医院药学杂志, 2019, 39(1): 92-96.
[31] 沈爱宗, 刘琳琳, 黄金柱, 等. 基于人工智能的药物治疗推荐功能介绍及应用效果分析[J]. 中国医院药学杂志, 2021, 41(17): 1764-1768.
[32] Huang, X.H., Yu, Z., Bu, S.H., et al. (2021) An Ensemble Model for Prediction of Vancomycin Trough Concentrations in Pediatric Patients. Drug Design, Development and Therapy, 15, 1549-1559. [Google Scholar] [CrossRef
[33] Huang, X.h., Yu, Z., Wei, X., et al. (2021) Prediction of Vancomycin Dose on High-Dimensional Data Using Machine Learning Techniques. Expert Review of Clinical Pharmacology, 14, 761-771. [Google Scholar] [CrossRef] [PubMed]
[34] Chen, H., Ma, Y.Y., Hong, N., et al. (2021) Early Warning of Citric Acid Overdose and Timely Adjustment of Regional Citrate Anticoagulation Based on Machine Learning Meth-ods. BMC Medical Informatics and Decision Making, 21, Article No. 126. [Google Scholar] [CrossRef] [PubMed]
[35] Zheng, P., Yu, Z., Li, L.R., et al. (2021) Predicting Blood Con-centration of Tacrolimus in Patients with Autoimmune Diseases Using Machine Learning Techniques Based on Re-al-World Evidence. Frontiers in Pharmacology, 12, Article ID: 727245. [Google Scholar] [CrossRef] [PubMed]
[36] Guo, W., Yu, Z., Gao, Y., et al. (2021) A Machine Learning Mod-el to Predict Risperidone Active Moiety Concentration Based on Initial Therapeutic Drug Monitoring. Frontiers in Psy-chiatry, 12, Article ID: 711868. [Google Scholar] [CrossRef] [PubMed]
[37] Feng, C.L., Chen, H.W., Yuan, X.Q., et al. (2019) Gene Expres-sion Data Based Deep Learning Model for Accurate Prediction of Drug-Induced Liver Injury in Advance. Journal of Chemical Information and Modeling, 59, 3240-3250. [Google Scholar] [CrossRef] [PubMed]
[38] He, X., Yao, P.L., Li, M.T., et al. (2021) A Risk Scoring Model for High-Dose Methotrexate-Induced Liver Injury in Children with Acute Lymphoblastic Leukemia Based on Gene Poly-morphism Study. Frontiers in Pharmacology, 12, Article ID: 726229. [Google Scholar] [CrossRef] [PubMed]