| Project/Area Number |
19K10501
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 58010:Medical management and medical sociology-related
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| Research Institution | Fujita Health University (2022)
Tokyo Metropolitan Tama Medical Center (Department of Clinical Research) (2019-2021) |
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Principal Investigator |
Honda Hitoshi 藤田医科大学, 医学部, 教授 (10770860)
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| Project Period (FY) |
2019-04-01 – 2023-03-31
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| Project Status |
Completed (Fiscal Year 2022)
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| Budget Amount *help |
¥3,250,000 (Direct Cost: ¥2,500,000、Indirect Cost: ¥750,000)
Fiscal Year 2021: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2020: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2019: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
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| Keywords | 感染症コンサルテーション / サインオフ / 患者安全 / 抗菌薬適正使用 / 医療安全 |
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| Outline of Research at the Start |
2000年の初頭より米国において医療安全、患者予後の観点からの感染症コンサルテーションの有用性は指摘されていた。米国では感染症医における感染症診療は極めて一般的であるが、日本では必ずしもそうでないことから日本における感染症医の役割を明確にすることが目的であり、感染症コンサルテーション終了後から退院までの感染症の発生や、抗菌薬治療における有害事象の発生を見ることも目的としている。
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| Outline of Final Research Achievements |
Infectious diseases (ID) consultation has contributed to improving outcomes in hospitalized patients. However, the timing of sign- ing off on ID consultation varies. The incidence of any treatment-related ADE after signing off, nonadherence to the final ID recommendations, and factors associated with nonadherence to the ID recommendations were identified. The incidence of post sign-off events during index hospitalization was 59 (16.1%) of 367, with antimicrobial-associated ADEs accounting for 26 events (44.1%) and HAIs accounting for 13 events (22.0%). After excluding patients who discontinued treatment, nonadherence to ID recommendations was identified in 55 (15.7%) of 351 patients. Newly acquired HAIs during the index hospitalization after signing off on ID consultation was an independent risk factor for nonadherence to ID recommendations (aOR, 3.78). Post sign-off events were common and led to nonadherence to ID recommendations during the post sign-off period.
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| Academic Significance and Societal Importance of the Research Achievements |
感染症コンサルテーションは大規模医療機関で一般的な診療形態になっているに際し、その質と患者安全の担保がより重要な状況になっているため、終診後の患者予後の評価をすることで、より理想的な感染症コンサルトの実施につながるような内容を探求することができた。
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