CN113380408B - Medicine taking behavior analysis system based on behavior-time guardrail - Google Patents
Medicine taking behavior analysis system based on behavior-time guardrail Download PDFInfo
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Abstract
The invention belongs to the technical field of chronic disease treatment and supervision, and particularly relates to a medicine taking behavior analysis system based on a behavior-time guardrail. The invention comprises the following steps: s1, establishing a medicine taking behavior index; s2, quantitatively calculating the medicine taking behavior indexes; s3, performing unified analysis. The invention can carry out quantitative analysis based on the current taking habit of the patient, thereby standardizing the behavior of the patient and developing the habit of taking medicine on time and in quantity according to the doctor's advice, improving the compliance and the automatic law of the patient and ensuring the timeliness and the continuity of the treatment of the patient.
Description
Technical Field
The invention belongs to the technical field of chronic disease treatment and supervision, and particularly relates to a medicine taking behavior analysis system based on a behavior-time guardrail.
Background
Chronic disease refers to the general term for diseases that do not constitute infections and have long-term accumulation of lesions that form the morphology of the disease; once the prevention and the control are not completed, the damage in the aspects of economy, life and the like can be caused. Chronic diseases generally exhibit the following characteristics: 1. the population cardinality is huge and the death rate is high. 2. Patient compliance is poor and risk of disease progression is high. 3. Medical expenses are rapidly increased and disease burden is heavy. Under normal conditions, the disease course of basic chronic diseases can be prevented and controlled, but serious complications of organisms are easily caused by irregular treatment, patients are disabled, mental loss and even death occur, and the mental and economic burden of the patients and families is further increased.
Therefore, the method for regulating the behaviors of the patients and developing the habit of taking medicines on time and in quantity according to the doctor's advice, and improving the compliance and the autonomy of the patients is a key means for preventing and controlling the disease process.
Disclosure of Invention
The invention aims to provide a medicine taking behavior analysis system based on a behavior-time guardrail for bad medicine taking behaviors of a current patient, which can conduct quantitative analysis based on the current medicine taking habit of the patient, so that the behavior of the patient is standardized, the habit of taking medicine on time and in quantity according to medical advice is formed, the compliance and the automatic compliance of the patient are improved, and the timeliness and the continuity of treatment of the patient are ensured.
In order to achieve the above purpose, the present invention adopts the following technical scheme:
the medicine taking behavior analysis system based on the behavior-time guardrail is characterized by comprising the following steps of:
s1, establishing medicine taking behavior indexes
Setting the time when the patient should take the medicine, namely the time when the patient is recommended to take the medicine in the treatment scheme; taking the medicine taking time and the actual medicine taking time of a patient as parameters to establish a risk model to form a risk level shaft; the risk level axis takes the time of the current action of taking medicine as the origin of coordinates, and extends the origin of coordinates to the left and right for a specified time to form a current correct medicine taking time guardrail, so as to obtain the time length t of the nth correct medicine taking event n ；
Setting allowable delay medicine taking time period r Container with a cover Is that
S2, quantitative calculation of medicine taking behavior indexes
Three types of behavior are set, namely:
class a behavior, i.e. correct dosing event, with a weight of a, a being positive;
obtaining the cumulative score = correct number of doses x a of class a behavior of the patient in the target days;
class B behavior, i.e. delayed medication events, with a weight B, B being negative;
obtaining the accumulated score of the B-class behaviors of the patient in the target days, namely the score corresponding to the delayed medicine taking event of all the target days
And (3) summing; />
Wherein, two end points of the guardrail at the correct taking time are taken as standard points, t b The time length of the nearest standard point for the delayed taking action occurrence point;
class C behavior, i.e., early medication event and/or missed medication event, with a weight of C, C being negative;
obtaining the accumulated score of the early taking action of the patient in the target days, namely the score corresponding to the early taking event of all the target days
And (3) summing;
wherein, two end points of the guardrail at the correct taking time are taken as standard points, t c The time length of the nearest standard point for the point of occurrence of the early taking action;
obtaining the accumulated score = missed number of times c of missed drug behaviors of the patient in the target days;
the final score of the patient over the target days = the cumulative score of class a behavior + the cumulative score of class B behavior + the cumulative score of class C behavior;
in conclusion, the method comprises the steps of,
s3, unified analysis
And setting an allowable behavior specification threshold, and when the behavior specification rate of the patient exceeds the allowable behavior specification threshold, generating a risk warning and outputting the warning by the system until the behavior specification rate of the patient is smaller than or equal to the allowable behavior specification threshold.
Preferably, a minimum analysis period is set; the minimum analysis period T consists of three parts, namely a 'correct medicine taking time guardrail', a 'delayed medicine taking time guardrail' and a time period from the last 'delayed medicine taking time guardrail' of a certain medicine taking event to the front of the 'correct medicine taking time guardrail'; under the condition that the early taking event does not occur in the minimum analysis period T, the taking event should occur in the 'correct taking time guardrail', the situation that the delayed taking or the medicine missing event is about to occur is indicated, and the delayed taking or the medicine missing event is defined as a potential risk time window;
counting the frequency of each potential risk time window in the target days, and sequencing the daily potential risk time windows according to the frequency; the risk of the 'correct taking time guardrail' corresponding to the potential risk time window with higher frequency is higher, namely the risk of delayed taking and missed taking of the medicine in the preset taking interval is higher, until the preset value is exceeded, the system sends out a high risk warning to the patient and/or guardians and/or public health service institutions at the moment so as to ensure that the patient takes medicines regularly.
Preferably, a risk time window analysis chart based on 'time-behavior' close association is established by taking T as an abscissa and taking calendar days of taking behaviors as an ordinate; marking a correct taking time guardrail on the risk time window analysis chart, and respectively marking occurrence points of 'delayed taking behaviors', occurrence points of 'advanced taking behaviors' and occurrence points of 'medicine missing behaviors', wherein the longer the offset time of the corresponding occurrence points from the correct taking time guardrail is, the higher the risk is; the system sends risk time window analysis maps to the patient and/or guardian and/or public health service entity to ensure that the patient is dosed.
Preferably, the target number of days is thirty days, and:
monitoring final integration of the patient within thirty days, the behavior standardization rate of the patient, the occurrence rate of the B-class behavior of the patient and the occurrence rate of the C-class behavior of the patient, and drawing a statistical chart, so that the patient, the guardian or the public health service institution can compare before and after, and the taking behavior of the patient can be further standardized.
Preferably, the allowable delayed administration time period r Container with a cover ＝0.5。
The invention has the beneficial effects that:
1) According to the scheme, the behavior-time guardrail of the patient for safe medication can be scientifically set, different behavior-time guardrails can be differently reminded, and forbidden warning indication can be carried out on the behavior outside the guardrail. In other words, the patient sets the correct taking time according to the doctor's advice, but taking the medicine for a period of time not specified often occurs due to subjective or objective reasons, so that taking supplementary measures (delayed taking) are needed to ensure the duration of the curative effect, and at the same time, avoiding the physical damage caused by the excessive blood concentration due to the superposition with the next taking period. Therefore, when formulating the supplementation scheme (delayed administration), the doctor can make the allowable supplementation time range or time ratio r between two administrations according to the pharmacokinetics, pharmacodynamics characteristics, individual difference of patients and clinical experience of the medicine Container with a cover And then, taking the reference point as an extension time delay medicine taking interval and an advance medicine taking interval, and carrying out quantitative calculation and system monitoring on the medicine taking interval. And comparing the result of quantitative calculation with a set threshold value, thereby determining risk warning and outputting the risk warning to a patient, a doctor or related personnel and the like so as to continuously adjust the taking behavior, and finally continuously optimizing the taking behavior to form a reasonable treatment scheme which is more suitable for the patient's action and rest law.
Through the adjustment, the invention can solve the problem that the chronic patient cannot clearly or timely know the risks brought to treatment by illegal taking behaviors in the taking process, normalize the behaviors of the patient, develop the habit of taking medicines on time and in quantity according to the doctor's advice, improve the compliance and the automatic law of the patient, ensure the timeliness and the continuity of the treatment of the patient and have remarkable effect.
2) Based on the scheme, the invention can further perfect a patient illegal behavior evaluation system based on a behavior-time guardrail, which is formed independently or in combination based on the following points:
firstly, by setting up a potential risk time window, namely counting the non-taking behaviors as potential risks when taking medicines normally, if the occurrence rate of the behaviors exceeds a preset value, the system monitors and sends corresponding warnings so as to continuously adjust the bad behaviors of the patient.
Secondly, a risk time window analysis chart capable of being directly and visually monitored is manufactured, so that the offset duration of each bad behavior occurrence point from the correct medicine taking time guardrail is judged, the treatment scheme is reasonably planned, and the standard medicine taking of a patient is ensured.
Thirdly, an improved auxiliary decision-making system is established, namely, through integrating the occurrence rate of each bad behavior and even drawing a chart, the patient, the guardian or the public health service organization can continuously compare the front and back taking behaviors in the whole taking progress of the patient, so that the taking behaviors of the patient can be continuously optimized and standardized in the whole taking progress.
Through the operation, the invention forms the medicine taking action track based on time so as to further adjust a reasonable treatment scheme more suitable for the action and rest rules of the patient, and continuously verifies or adjusts the treatment scheme through the front-back comparison of each data, so that the treatment scheme is more reasonable for the illness state of the patient, and obviously helps to remarkably improve the actual treatment effect.
Drawings
FIG. 1 is a time diagram of a correct dosing time bar;
FIG. 2 is a time diagram of a delayed medication time barrier;
FIG. 3 is a time axis diagram of an analysis period unit;
FIG. 4 is a time-axis diagram of the actual delayed medication behavior of a patient;
FIG. 5 is a time-axis diagram of the actual early medication behavior of a patient;
FIG. 6 is a time chart of two cycles of analysis of the taking behavior of a patient, i.e., two analysis cycle units, in the example;
fig. 7, 8, 9 and 10 are graphs of risk time window analysis of patients based on three drug bins, four dosing time periods in the examples.
Detailed Description
For ease of understanding, the specific structure and operation of the present invention will be further described herein below with reference to FIGS. 1-10 by way of example of a smart kit. Of course, in actual use, the corresponding data may be obtained by directly performing clinical observation on the patient instead of only using the medicine box, and will not be described here.
The specific system structure of the invention comprises the following parts:
1. behavior-time guardrail subsystem
(1) User information setting module
(1) The terminal equipment is bound with the identity of the patient through a mobile phone WeChat or a computer terminal, and the binding information comprises, but is not limited to, name, age, gender, reference assurance number, identity card number, contact way and guardian (relatives, family doctor, etc.).
(2) The patient sets the name of oral medicine, single dose and time of taking medicine through the mobile phone. In addition, the medicine name can be automatically filled in a mode of scanning a traceability code, and specification information is stored.
(2) Definition and setting module of behavior-time guard bar
(1) The behavior-time guardrail comprises a correct taking time guardrail and an allowable delayed taking time guardrail.
a. Define "correct dosing time guard bar".
Setting a correct medicine taking time point 0 according to a doctor's advice, wherein the correct medicine taking time period is defined as a correct medicine taking time period with + -certain time, and the medicine taking behavior in the time period is defined as a correct medicine taking behavior, and the time length is t n And establishes a "correct dosing time guard bar" at this time period. The current administration event is defined as an nth administration event, the last administration event is defined as an nth-1 administration event, and the next administration event is defined as an (n+1) th administration event. At this time, the nth administration event is to be performedThe starting point of the 'correct medicine taking time guardrail' is the time length t from the end point of the 'correct medicine taking time guardrail' of the nth-1 time of the response medicine taking event n-1 The method comprises the steps of carrying out a first treatment on the surface of the The end point of the 'correct medicine taking time guard bar' of the nth medicine taking event is a time length t from the start point of the 'correct medicine taking time guard bar' of the (n+1) th medicine taking event n+1 . With particular reference to fig. 1.
b. Defining maximum allowable delay medicine taking time interval ratio' r Container with a cover ”。
According to the pharmacokinetics and pharmacodynamics characteristics of a certain medicine and the individual difference of the past clinical channel and the patient, the time length which accords with the allowable delay medicine taking of the patient is purposefully formulated, and the ratio of the time length of taking the medicine twice to the time length of taking the medicine correctly is r Container with a cover . R is in general case Container with a cover ＝0.5。
c. Define a "delayed medication time barrier".
R of the same patient taking the same medicine Container with a cover Is a fixed value; at this time, as shown in FIG. 2, the allowable delayed medication time length of the nth medication event is t n+1 *r Container with a cover 。
2. Behavior data acquisition subsystem
(1) Patient behavior definition module
(1) An analysis period unit of patient behavior, i.e. a minimum analysis period T, is defined.
T consists of a correct taking time guardrail of the nth taking event and a delayed taking time guardrail thereof, and a time period from the time of the nth-1 taking event to the time of the nth taking event before the correct taking time guardrail, namely T=t n-1 *(1-r Container with a cover )+t n+1 *r Container with a cover With particular reference to fig. 3.
(2) Patient behavior types are defined.
In a T, according to the relationship between the actual taking time of the patient and the "behavior time guardrail", the behavior type of the patient can be defined as follows at most:
i, accurately taking medicine, namely, the time of taking medicine event is positioned in a 'accurately taking medicine time guardrail';
II, delaying taking action, namely, the time of taking an event is positioned in a delayed taking time guardrail;
III, taking medicine in advance, namely, taking medicine in time of occurrence of an event is positioned in a time period from the last time of 'delayed taking medicine time guard rail' to the time of 'correct taking medicine time guard rail';
IV, repeating the medication behavior, namely, in an analysis period unit T, the actual medication time occurrence times of patients are more than or equal to 2;
v, medicine leakage behavior, namely, the actual medicine taking time occurrence frequency of a patient is 0 in one analysis period unit T.
VI, other special event behaviors, such as temporary emergency medication or drug replacement, can be marked by special behaviors through the function keys, and remarks are made on the behaviors at the mobile phone end.
3. Establishing a behavior-time guardrail indicating subsystem for an intelligent medicine box
(1) The behavior of the "correct taking time guard rail" indicates.
When the preset correct medicine taking time is reached, the indicator lamp system is lightened or blinks, the buzzer of the intelligent medicine box sounds, and the medicine taking reminding module enters a calm state until the bin gate is opened and closed for 1 time in the time period, or the bin gate is not opened but the time reaches the end point of the 'correct medicine taking time guardrail'.
(2) The behavior indication of the delayed medicine taking time guard bar.
The medicine bin gate is not opened in the 'right medicine taking time guardrail', and in the first 'delayed medicine taking time guardrail', the indicator light system of the intelligent medicine box is lightened and/or the flashing state and/or the buzzer sound is changed differently from the state (1) until the bin gate is opened in the time period, or the bin gate is not opened but the time reaches the 'delayed medicine taking time guardrail', so that the delay reminding module enters a static state.
(3) Abnormal or special behavioral cues.
The bin gate is triggered outside the behavior-time guardrail, such as taking medicine in advance; or triggering the bin gate in one analysis period unit T twice or more, such as repeated medication; or when medicines are replaced and medicines are taken in advance in emergency, when the bin gate is opened, the indicator light system is lightened and/or the state of flashing and/or the sound of the buzzer is changed differently from the states (1) and (2); after the bin gate is closed, the reminding module enters a static state.
4. Behavior evaluation subsystem based on behavior-time guardrail
(1) Behavior evaluation index setting module
(1) The dosing should follow the instructions of the "behavior-time barrier" instruction system, within one analysis period T:
defining class A behaviors as standard behaviors, wherein the behaviors occur on a 'correct medicine taking time guardrail' for the first time;
defining the B type behavior as an un-recommended behavior, namely, the behavior occurs in a 'delayed medicine taking time guardrail' for the first time;
class C behavior is defined as prohibited behavior, i.e., behavior that occurs for the first time outside the "behavior-time barrier" or occurs 2 times or more in one analysis period T or occurs 0 times in one analysis period T.
A. The B, C behaviors are respectively given with weights a, b and c, so that comparison and analysis are facilitated.
(2) In order to embody the differentiation of the illegal behaviors, an evaluation system taking the boundary of the 'correct taking time guardrail' as a core is established for the same type of behaviors such as the B type behaviors or the C type behaviors in an analysis period T.
Differentiated scoring of I.B class behavior
Referring to fig. 4, the rightmost end of the "correct administration time guard rail" is taken as a standard line, and the time length of the event occurring in the "delayed administration time guard rail" from the standard line is t b The score of this behavior is
Differentiated scoring of early dosing in class II C behavior
With reference to FIG. 5, the medicine is taken correctly for a long timeThe leftmost end of the column is a standard line, the time length from the standard line is t, which occurs after the last time of the medicine taking delay time guard rail and before the last time of the medicine taking delay time guard rail c The score of the action of taking medicine in advance at this time is
(2) Long-term tracking evaluation index setting module
(1) Behavior score and behavior normalization rate.
I. Behavioral integration
And accumulating the times of behavior occurrence and the corresponding weights of the behavior occurrence in a certain period by taking the class A behavior weight a as a positive value and the corresponding weights b and c of B, C behaviors as negative values.
Behavior normalization rate
The score of behavior over a period of time divided by the score of response assuming that the behavior is all correct over a period of time.
(2) B, C occurrence of behavior.
I. And in a certain period, the ratio of the occurrence times of the B-class behaviors to the occurrence times (the opening times of the bin gate) of the total medicine taking events is the occurrence rate of the B-class events.
And II, in a certain period, the ratio of the occurrence times of the C-class behaviors to the occurrence times (the opening times of the bin gate) of the total medicine taking events is the occurrence rate of the C-class events. The C-class behavior can be refined according to the taking of medicines in advance, the repeated taking of medicines and the taking of medicines which are missed, such as the respective times of taking of medicines in advance, the repeated taking of medicines and the taking of medicines which are missed are divided by the total times of taking events or the total times of taking events of the C-class to obtain respective ratios.
The system dynamically monitors the behavior score, the behavior standardization rate and the occurrence rate of the B and C type behaviors, draws a statistical chart, is convenient for the front and back comparison of patients, guardians or public health service institutions (such as community health service centers), and further standardizes the taking behaviors.
5. Behavior correction auxiliary decision-making subsystem based on behavior-time guardrail
Aiming at the behavior of delayed medicine taking and medicine missing in the actual life, targeted behavior analysis is carried out regularly, potential risks are found, and correction comments are put forward.
The time window of potential risk is defined, namely a behavior analysis period unit or minimum analysis period T, and the time window consists of a 'correct medicine taking time guardrail', a 'delayed medicine taking time guardrail', and a time period from the last 'delayed medicine taking time guardrail' to the front of the 'correct medicine taking time guardrail'. In the case that an early medication event does not occur within the minimum analysis period T, a "correct medication time bar" should occur without a medication event, indicating that a delayed medication or a missed medication event is about to occur, i.e. a "correct medication time bar" without a bin gate trigger event is defined as a potential risk time window.
Counting the frequency of different potential risk time windows in a certain period, and sequencing the daily potential risk time windows according to the frequency, wherein the risk of the 'correct medicine taking time guardrail' corresponding to the potential risk time window with higher frequency is higher, namely the risks of delayed medicine taking and medicine missing in the preset medicine taking interval are higher. The system automatically sends out the time window setting or the high risk early warning report of the 'correct administration time guardrail' to a patient, a guardian or a public health service institution (such as a community service center), and carries out questionnaire investigation or on-line and off-line manual follow-up, and the patient or guardian and the public health service personnel (community doctor) can feed back investigation results in a mode of checking or simple text setting; meanwhile, the system gives guidance comments including prescription adjustment and medicine taking behavior correction for high-risk behavior events in a relatively fixed time period.
Example 1
For ease of understanding, the invention will be further described herein by the following examples, which are incorporated herein by reference in their entirety:
1. patient base information is as follows table 1:
TABLE 1
2. Intelligent medicine box medicine taking setting:
The patient scans the two-dimension code of the intelligent medicine box through WeChat, binds the user, inputs personal basic information and disease information, and simultaneously sets a guardian for family doctors who are relatives and friends and communities.
Step 2, drug information setting
Taking metoprolol as an example, a patient clicks a medicine bin No. 1 on a WeChat applet to enter a medicine adding interface, and automatically fills in the medicine name of the medicine bin No. 1 by directly scanning the tracing code on the outer package of the oral antihypertensive medicine metoprolol and notes the specification of the medicine; after the medicine name is set, the taking time point and the dosage are set, namely 7 points and 16 points are set as taking time points respectively, and each medicine is taken once a day.
Step 3, "behavior-time" setup
In a default state, the system takes 7 points and 16 points as datum points, and a section of +/-30 minutes of each datum point is regarded as a correct taking time period, namely the correct taking time period of metoprolol on the same day is 6:30-7:30 and 15:30-16:30 respectively.
R in default state Container with a cover The allowable delayed medication period is half the period of time from the end of the current correct medication period to the end of the next correct medication period. Taking the first administration of the present nimesulol as an example, fig. 6 shows:
the correct time period for the first medicine taking is 6:30-7:30, and the starting point of the second correct medicine taking on the same day is 15:30, the interval between two administrations is 8 hours, namely 7:30-15:30, the maximum allowable delayed dose for the first dose is 4 hours, i.e. the allowable delayed dose period is 7:30-11:30. furthermore, today first dose time point 6:30, maximum allowable delayed dosing endpoint 23 for previous round of dosing: 30, which is the prohibited taking time zone or the advanced taking time zone.
As can be seen from fig. 6: from yesterday 23:30 to today 11:30 is the first behavioral analysis cycle of metoprolol, comprising three "behavioral periods", namely "early dosing period" 23:30-6: 30. "correct dosing period" 6:30-7:30, "allowable delayed dosing period" 7:30-11:30. in addition, the number of times of oral administration (door opening and closing) of not less than 2 was defined as repeated administration and the number of times of administration=0 was defined as missed administration in this analysis period unit (23:30 to 11:30).
3. Indication and early warning of taking behavior
Taking the first medicine taking of the metoprolol today as an example, the LED indicator lights of the system flash in gray in the period of 6:30-7:30 of the correct medicine taking time period, and meanwhile, the buzzer sends out prompt sounds to guide the patient to take medicine correctly. In addition, the act, indication or pre-alarm event associated with the time period medication event further includes:
(1) if the medicine is taken 1 time (the bin gate is opened and closed 1 time) in the period of 6:30-7:30, the indicator lamp and the buzzer stop working and enter a dormant state; until the bin gate is accidentally opened or enters the next correct administration time period;
(2) if no medications were taken during the 6:30-7:30 period (door not open), the system enters the allowable delay medication phase, i.e., at 7:30-11: the LED lamp of the indication system flashes yellow in the 30 time period, and meanwhile, the buzzer sends out prompt tones to remind a patient of grasping time and take medicine as soon as possible;
(3) if 7:30-11: the medicine is taken for 1 time in 30 periods, the indicator lamp and the buzzer stop working and enter a dormant state until the bin gate is opened or the next correct medicine taking time period is entered;
(4) if 7:30-11:30, if the medicine is not taken, the indicator light and the buzzer are at 11:30 stop working and enter a sleep state until the bin gate is opened or enters the next correct dosing period.
The LED indicator light of the intelligent medicine box can not only indicate the patient to take medicine correctly in gray and remind the patient to take medicine as soon as possible to avoid delay, but also has the function of warning the patient to prohibit starting medicine in red.
In fig. 6, the advanced dosing interval 23 in the first dosing behavior analysis cycle: 30-6:30, prohibiting the bin gate from being opened in the time period, enabling the indicator light and the buzzer to be in a dormant state in a normal state, and if the bin gate is opened in the time period, enabling the LED indicator light to flash in red and enabling the buzzer to give out prompt tones to warn a patient to prohibit taking medicine under non-special conditions. In addition, in the analysis period of the first medicine taking behavior, if the bin gate is opened for the second time or more, the LED indicator lamp flashes red and the buzzer sends out prompt tones to warn the patient that the repeated medicine taking risk exists.
4. Establishing evaluation index of taking medicine behavior and auxiliary decision of behavior correction
Assuming that the patient should take the medicine correctly 120 times within 30 days of a month, the actual taking of the medicine correctly 103 times, the taking behavior is not normalized for 17 times: delay for 14 times, advance for 1 time and miss for 2 times, and the basic information of taking medicine is as follows in table 2:
table 2 wherein the patient's 17 non-normative dosing schedule is as follows table 3:
TABLE 3 Table 3
Based on the above tables 2 and 3, the following procedure was performed:
firstly, establishing evaluation indexes of taking behavior
In order to develop the evaluation of the medicine taking behavior, an index evaluation system aiming at the behavior is firstly established, the measurability and the comparability of the behavior are realized through the quantitative analysis of indexes, the long-term tracking and the monitoring can be realized, and the data support is provided for dynamically formulating an intervention scheme. The embodiment focuses on three indexes of behavior integration, behavior standardization rate and non-standardization behavior occurrence rate of the patient for taking medicines.
(1) Patient taking action score
The nonstandard behaviors of the patient in this embodiment include: non-suggested class B behavior and forbidden class C behavior. In an embodiment, the patient does not suggest that the class B behavior be delayed medication, and the prohibited class C behavior be advanced medication, missed medication. The weight of the patient class a behavior a=1, the weight of the patient class B behavior b= -1, the weight of the patient class C behavior c= -1.
From Table 3, t is known b =30 min; t is t n+1 = (7 hours×2) ×60 minutes; r is (r) Container with a cover =0.5, then:
from the formula
The score for the patient's class B behavior on the first day, i.e., 2021, month 4, 1, was calculated as:
The corresponding delay ratios are calculated and obtained respectively and filled in the last column of table 3 to form the complete table 3.
Then, the cumulative score of the class B behavior over 30 days for the patient is:
(0.071+0.214+0.071+0.107+0.286+0.190+0.143+0.262+0.167+0.238+0.130+0.174+0.043+0.087)×(-1)＝-2.185；
similarly, by the formula
The cumulative score of early dosing in class C behavior in 30 days of the patient was calculated: -0.071; the missed medicine in the C class behavior is calculated according to the missed times multiplied by weight, namely 2× (-1) = -2;
the cumulative score of class a behavior in 30 days of the patient was =correct number of doses xa=103×1=103;
final score within 30 days of the patient = class a score + class B score + class C score = 103-2.185-0.071-2 = 98.744.
(2) Rate of behavior specification for patients
In the examples, the patient's 30-day behavior normative rate = actual score/assumed behavior was all correct x 100%, i.e. 98.744/120 x 100% = 82.3%.
At this time, an allowable behavior specification threshold, such as 95%, for the behavior specification rate of the patient may be set. Since 82.3% is less than 95%, the system may issue a risk warning.
(3) Incidence of patient non-canonical behavior
①
②
Wherein, the C-class behavior can further subdivide the incidence of taking medicines in advance, repeatedly taking medicines and missing medicines.
In this embodiment, the taking behavior score, the behavior standardization rate, the occurrence rate of the B-class and the C-class behaviors of the patient within 30 days are calculated to obtain the result, the result can be dynamically analyzed month by month later, and the month result is drawn into a statistical chart, so that the patient, the guardian or the public health service organization (such as a community health service center) can be conveniently compared front and back, the dynamic monitoring is performed, and the standardization degree of the patient behavior is continuously improved.
(II) combining the behavior tracks through a risk time window to provide auxiliary decision
In this embodiment, we use "one behavior analysis period" corresponding to a certain medicine bin as the abscissa and use the calendar day of the medicine taking behavior as the ordinate to build a risk time window analysis chart or a behavior track analysis chart based on the close association of "time-behavior". The following are provided:
the left and right boundaries of the gray column are respectively two sides of a guardrail for the correct taking time, namely the starting-stopping points for the correct taking time; the right side of the gray column is a set 'delayed medicine taking time guardrail' area; the gray column left is the "take ahead of medicine" zone, which is normally prohibited.
In this embodiment, the "correct medication" is not marked; the time-delay medicine taking behavior is marked on a coordinate graph in a dot form according to the occurrence date and time point, and the length of an arrow line connected with the time-delay medicine taking behavior represents the offset time length of the time-delay behavior and the standard behavior. In addition, the "take ahead behavior" that is conventionally prohibited is represented by dots that can be of other colors, and the length of the arrow line connected thereto represents the offset time from the normative behavior; "drug leakage behavior" is indicated by circles. The final result is the graphs shown in fig. 7-10.
The three medicine bins and four medicine taking time periods of the embodiment are analyzed by a risk time window, so that visual judgment can be made:
1. in general, the patient takes medicine in a state of following the indication lamp and the buzzer, no lamplight or buzzer is used for guiding the patient in the period of taking medicine in advance, and the patient cannot actively start the medicine box to take medicine unless emergency or special conditions are met. In this embodiment, as shown in fig. 7, the patient actively opens the medicine bin in advance at 6 morning on 4 months and 16 days without signal guidance, and may encounter an emergency, and the system automatically records and sends an abnormal behavior report to the guardian or community family doctor.
2. As can be seen in fig. 8, the patient's irregular behavior type is mainly "delayed medication," exhibiting "aggregation," and the actual taking behavior is mostly located at afternoon 17:00-18:00, which is separated from the original preset 15:30-16:30 "correct administration time guardrail", the original preset "correct administration time" has potential risks of delayed administration and even missed administration. Therefore, the originally preset "correct administration time guardrail" is a "risk time window", and intervention measures need to be taken.
Through timely communication and follow-up visit with patients, the following discovery is carried out:
(1) The time of oral antihypertensive metoprolol is 6:30-7:30, but the recent sleep is poor, after 4 months and 16 days, dizziness and palpitation are detected, the self-pressure is 160mmHg, and then the antihypertensive drug metoprolol is orally taken in advance. The feedback information is timely fed back to guardianship and community family doctors, and then positive intervention measures are adopted, such as the family members actively communicate with the patients, so that the heart state is stable, the bad moods such as tension and anxiety are eliminated, and the frequency of monitoring the blood pressure of the patients is enhanced; the community family doctors pay close attention to blood pressure changes, and the prescriptions are to be adjusted according to actual conditions, such as changing long-acting antihypertensive drugs, increasing doses or jointly using antihypertensive drugs; and the multiple parties struggle together to reduce the sudden accidents of the cardiovascular and cerebrovascular diseases to the greatest extent.
(2) The patient has entertainment preference on weekdays, and the game room usually reaches the neighborhood after lunch for entertainment until the patient is ready for dinner. Thus, there is often a miss 15 as shown in FIG. 8: 30-16:30 times of taking the medicine.
Through communicating with guardians and community family doctors, an improvement scheme is provided for patients: (1) the life style is properly changed, and the residence time of the chess and card room is shortened; (2) the prescription is adjusted according to the requirements, namely, under the condition that (1) the prescription is not adopted by patients, long-line antihypertensive drugs can be replaced or the administration time can be adjusted, and the curative effect is closely observed, so that the timeliness and the continuity of the hypertension treatment of the patients are ensured.
It will be understood by those skilled in the art that the present invention is not limited to the details of the foregoing exemplary embodiments, but includes other specific forms of the same or similar structures that may be embodied without departing from the spirit or essential characteristics thereof. The present embodiments are, therefore, to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims rather than by the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein. Any reference sign in a claim should not be construed as limiting the claim concerned.
Furthermore, it should be understood that although the present disclosure describes embodiments, not every embodiment is provided with a separate embodiment, and that this description is provided for clarity only, and that the disclosure is not limited to the embodiments described in detail below, and that the embodiments described in the examples may be combined as appropriate to form other embodiments that will be apparent to those skilled in the art.
The technology, shape, and construction parts of the present invention, which are not described in detail, are known in the art.
Claims (5)
1. The medicine taking behavior analysis system based on the behavior-time guardrail is characterized by comprising the following steps of:
s1, establishing medicine taking behavior indexes
Setting the time when the patient should take the medicine, namely the time when the patient is recommended to take the medicine in the treatment scheme; taking the medicine taking time and the actual medicine taking time of a patient as parameters to establish a risk model to form a risk level shaft; the risk level axis takes the time of the current action of taking medicine as the origin of coordinates, and extends the origin of coordinates to the left and right for a specified time to form a current correct medicine taking time guardrail, so as to obtain the time length t of the nth correct medicine taking event n ；
Setting allowable delay medicine taking time period r Container with a cover Is that
S2, quantitative calculation of medicine taking behavior indexes
Three types of behavior are set, namely:
class a behavior, i.e. correct dosing event, with a weight of a, a being positive;
obtaining the cumulative score = correct number of doses x a of class a behavior of the patient in the target days;
class B behavior, i.e. delayed medication events, with a weight B, B being negative;
obtaining the accumulated score of the B-class behaviors of the patient in the target days, namely the delayed administration event of all the target daysCorresponding score
And (3) summing;
wherein, two end points of the guardrail at the correct taking time are taken as standard points, t b The time length of the nearest standard point for the delayed taking action occurrence point;
t n+1 the time length from the start point of the "correct medicine taking time guard bar" of the (n+1) th medicine taking event is the end point of the "correct medicine taking time guard bar" of the (n) th medicine taking event;
class C behavior, i.e., early medication event and/or missed medication event, with a weight of C, C being negative;
obtaining the accumulated score of the early taking action of the patient in the target days, namely the score corresponding to the early taking event of all the target days
And (3) summing;
wherein, two end points of the guardrail at the correct taking time are taken as standard points, t c The time length of the nearest standard point for the point of occurrence of the early taking action;
t n-1 the starting point of the 'correct taking time guardrail' for the nth taking event is the time length from the end point of the 'correct taking time guardrail' for the nth-1 taking event;
obtaining the accumulated score = missed number of times c of missed drug behaviors of the patient in the target days;
the final score of the patient over the target days = the cumulative score of class a behavior + the cumulative score of class B behavior + the cumulative score of class C behavior;
in conclusion, the method comprises the steps of,
s3, unified analysis
Setting an allowable behavior specification threshold, generating a risk warning and outputting the warning by the system when the behavior specification rate of the patient exceeds the allowable behavior specification threshold until the behavior specification rate of the patient is smaller than or equal to the allowable behavior specification threshold;
setting a minimum analysis period; the minimum analysis period T consists of three parts, namely a 'correct medicine taking time guardrail', a 'delayed medicine taking time guardrail' and a time period from the last 'delayed medicine taking time guardrail' of a certain medicine taking event to the front of the 'correct medicine taking time guardrail'; in the case where an early medication event does not occur within the minimum analysis period T, a "correct medication time bar" should occur without a medication event, indicating an impending delayed medication or missed medication event, defined as a potentially risky time window.
2. A medication intake behavior analysis system based on behavior-time guardrails according to claim 1, characterized in that: counting the frequency of each potential risk time window in the target days, and sequencing the daily potential risk time windows according to the frequency; the risk of the 'correct taking time guardrail' corresponding to the potential risk time window with higher frequency is higher, namely the risk of delayed taking and missed taking of the medicine is higher until the preset value is exceeded, and at the moment, the system sends out a high risk warning to the patient and/or guardians and/or public health service institutions so as to ensure that the patient takes medicines regularly.
3. A medication intake behavior analysis system based on behavior-time guardrails according to claim 1, characterized in that: the T is taken as an abscissa, the calendar day of the taking action is taken as an ordinate, and a risk time window analysis chart based on the close association of time-action is established; marking a correct taking time guardrail on the risk time window analysis chart, and respectively marking occurrence points of 'delayed taking behaviors', occurrence points of 'advanced taking behaviors' and occurrence points of 'medicine missing behaviors', wherein the longer the offset time of the corresponding occurrence points from the correct taking time guardrail is, the higher the risk is; the system sends risk time window analysis maps to the patient and/or guardian and/or public health service entity to ensure that the patient is dosed.
4. A medication intake behavior analysis system based on a behavior-time barrier according to claim 1 or 2 or 3, characterized in that: the target days are thirty days, and:
monitoring final integration of the patient within thirty days, the behavior standardization rate of the patient, the occurrence rate of the B-class behavior of the patient and the occurrence rate of the C-class behavior of the patient, and drawing a statistical chart, so that the patient, the guardian or the public health service institution can compare before and after, and the taking behavior of the patient can be further standardized.
5. A medication intake behavior analysis system based on a behavior-time barrier according to claim 1 or 2 or 3, characterized in that: the allowable time delay medicine taking time period r Container with a cover ＝0.5。
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