C-5-05
Analysis of the Drug Prescribing Patterns of Physiciansin Patients with both Cardiac and Renal Failure
Mizuki Morita 1

Masanori Shiro 1

morita.mizuki@aist.go.jp

shiro@ni.aist.go.jp

Hideki Asoh 1

Toshihiro Kamishima 1

h.asoh@aist.go.jp

Koiti Hasida 3

mail@kamishima.net

hasida.koiti@i.u-tokyo.ac.jp

1

2
3
4
5

Shotaro Akaho 1s.akaho@aist.go.jp

Eiji Aramaki 2

eiji.aramaki@gmail.com

Takahide Kohro 4,5kohro-tk@rc5.so-net.ne.jp

National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono,
Tsukuba, Ibaraki 305-8568, Japan
Kyoto University, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, JapanThe University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, JapanThe University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan

Keywords: Clinical data analysis, Physician prescribing patterns, Markov decision process
Cardiac and renal functions are physiologically related through interactions between systemic
circulation regulation by the heart and extracellular fluid volume control by the kidney. Due to theincrease in the number of patients with hypertension and/or diabetes, the incidence of coexistentcardiac failure and renal failure is increasing. However, evidence for the establishment ofguidelines for treating patients with coexistent cardiac and renal failure is currently insufficientbecause patients with such complications are generally excluded from clinical trials. As a result,
such patients are generally treated on an empirical basis.
In the present study, we analyzed clinical data to clarify the current medical treatment process inhospital. We evaluated the medical records of patients with cardiac failure from the database of
The University of Tokyo Hospital. We modeled a series of treatments by physicians using theMarkov decision process (MDP), wherein the laboratory data of the patient were employed as thestate and the following drug prescription by the physician was employed as the action.
We identified the prescribing patterns of physicians according to the cardiac and renal state of thepatients. Moreover, we also determined the overall trend of the subsequent state as a result of eachprescription. Although most drugs were used under the recommended conditions according to thepackage inserts, these guidelines were not followed for certain other drugs. Only the present andsubsequent states were considered in this study, but we are planning to perform further studies toidentify more specific prescribing patterns according to the series of past states and changes in thetrend of states.
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