Oren Eyal, Shaffer Ellen R, Guglielmo B Joseph
Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, USA.
Am J Health Syst Pharm. 2003 Jul 15;60(14):1447-58. doi: 10.1093/ajhp/60.14.1447.
Published evidence on the effects of computerized physician order entry (CPOE), automated dispensing machines (ADMs), bar coding, and computerized medication administration records (CMARs) on medication errors and adverse drug events (ADEs) were reviewed. Emerging technologies have been recommended as potential mechanisms for reducing medication errors. Critical evaluations of the impact of these new technologies on medication errors and other adverse outcomes are lacking. PubMed was searched to identify all peer-reviewed publications linking four technologies (CPOE, ADMs, bar coding, and CMARs) with reductions in medication errors and ADEs and secondary endpoints. All controlled studies that assessed the impact of the technologies were evaluated. The appropriateness of the use of these technologies was also examined. Few studies were identified that evaluated the technologies' impact on these endpoints. Of the evaluated technologies, CPOE was the most studied; however, investigations were limited to selected medical centers. The appropriateness of use of the technologies was evaluated even more infrequently. A literature review revealed a paucity of controlled, generalizable studies confirming the benefits of technologies intended to reduce medication errors and ADEs. Very little evidence on the appropriateness of the use of these technologies was found.
对已发表的关于计算机化医师医嘱录入(CPOE)、自动发药机(ADM)、条形码和计算机化用药记录(CMAR)对用药错误和药物不良事件(ADE)影响的证据进行了综述。新兴技术已被推荐为减少用药错误的潜在机制。但缺乏对这些新技术对用药错误和其他不良后果影响的批判性评估。通过检索PubMed以识别所有将四种技术(CPOE、ADM、条形码和CMAR)与用药错误和ADE减少以及次要终点相关联的同行评审出版物。对所有评估这些技术影响的对照研究进行了评估。还检查了这些技术使用的适当性。仅发现少数研究评估了这些技术对这些终点的影响。在所评估的技术中,CPOE的研究最多;然而,调查仅限于选定的医疗中心。对这些技术使用适当性的评估更是少见。文献综述显示,缺乏能证实旨在减少用药错误和ADE的技术益处的对照、可推广研究。几乎没有发现关于这些技术使用适当性的证据。