Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599-7573, USA.
Pharmacoepidemiol Drug Saf. 2010 Oct;19(10):1087-94. doi: 10.1002/pds.2024.
To explore the use of disproportionality analysis of medication error data as a novel method to identify relationships that might not be obvious through traditional analyses. This approach can supplement descriptive data and target quality improvement efforts.
Data came from the Medication Error Quality Initiative (MEQI) individual event reporting system. Participants were North Carolina nursing homes who submitted incident reports to the Web-based MEQI data repository during the 2006 and 2007 reporting years. Data from 206 nursing homes were summarized descriptively and then disproportionality analysis was applied. Associations between medication type and possible causes at the state level were explored. A single nursing home was selected to illustrate how the method might inform quality improvement at the facility level. Disproportionality analysis of drug errors in this home was compared with benchmarking.
Statewide, 59 drug-cause pairs met the disproportionality signal and 11 occurred in 10 or more reports. Among these, warfarin was co-reported with communication errors; esomeprazole, risperidone, and nitrofurantoin were disproportionately associated with transcription error; and oxycodone and morphine were disproportionately reported with name confusion. Facility-level analyses illustrate how descriptive frequencies and disproportionality analysis are complementary, but also identify different safety targets.
Exploratory analysis tools can help identify medication error types that occur at disproportionate rates. Candidate associations might be used to target patient safety work, although further evaluation is needed to determine the value of this information.
探索药物错误数据的不均衡性分析作为一种新方法的用途，以识别通过传统分析可能不明显的关系。这种方法可以补充描述性数据，并针对质量改进工作。
数据来自药物错误质量倡议（MEQI）个体事件报告系统。参与者是北卡罗来纳州的养老院，他们在 2006 年和 2007 年报告年度内向基于 Web 的 MEQI 数据存储库提交事件报告。对 206 家养老院的数据进行描述性总结，然后进行不均衡性分析。探索药物类型与州一级可能原因之间的关联。选择单个养老院来说明该方法如何为设施一级的质量改进提供信息。对该养老院的药物错误进行不均衡性分析与基准测试进行了比较。
全州范围内，有 59 对药物-原因对符合不均衡性信号，有 11 对在 10 份或更多报告中出现。其中，华法林与沟通错误同时报告；埃索美拉唑、利培酮和呋喃妥因与转录错误不成比例相关；而羟考酮和吗啡与名称混淆不成比例地报告。设施层面的分析说明了描述性频率和不均衡性分析是互补的，但也确定了不同的安全目标。
探索性分析工具可以帮助识别以不成比例的速度发生的药物错误类型。候选关联可以用于针对患者安全工作，尽管需要进一步评估来确定这些信息的价值。
