Karthikeyan Marimuthu, Lalitha Devi
Al Shifa College of Pharmacy, Poonthavanam post Kizhattur Perinthalmanna, Kerala, India.
Drug Metabol Drug Interact. 2013;28(1):13-21. doi: 10.1515/dmdi-2012-0032.
The aim of the study was to evaluate the incidence of medication error and to categorize medication error in the general medicine department of a tertiary hospital. Thus, the study aims to promote safety in medication use and ensure quality in the healthcare service by effective utilization of a clinical pharmacist. The study objective was to detect and categorize medication errors, to ensure rational drug use in the hospital, to make recommendations for doctors, nurses, and patients to promote safe use of medications.
The study was conducted in inpatients in the general medicine department of a 350-bed multispecialty tertiary care referral hospital located in South India. It is a prospective observational study where data were collected using a data collection form which included patient demographic details, drug details, and criteria for identifying errors, its categorization, and the details of drugs involved in errors. Complete details of patients and medications were recorded through a review of medication charts, reviewing prescriptions, visiting nursing stations and the pharmacy, and personal interviews with patients and bystanders. Collected details were then evaluated to detect the prescribing, administration, dispensing error and drug interactions and were then recorded, suggesting necessary steps to prevent recurrence of reported medication errors.
The study was conducted in 311 patients, where 168 were males (54%) and 143 were females (46%). Out of 311 cases, 36 cases (11.57%) had at least one error. The total number of errors found was 67, among which administration errors (28.35%) were the most frequently occurring types of errors, which was followed by prescribing errors (22.38%), dispensing errors (8.9%) and drug interaction, patient errors and other types of errors collectively contributed to the remaining portion. A total of 2742 medications were prescribed to 106 patients and the average number of medications per patient was found to be 8.8. The involvement of a particular medication class to the medication errors showed that the antimicrobial agents were contributing a maximum of (26.8%), which was followed by cardiovascular agents (20.8%). In third place were nonsteroidal anti-inflammatory drugs (11.9%) followed very closely by central nervous system drugs and gastrointestinal drugs (7.4%). The total percentage of drug interaction was 40.29%. Most interactions were of moderate type belonging to category C of medication errors.
The study helps to assess the incidence of medication error and to categorize medication error. In the general medicine department, the majority of patients were geriatrics who are more prone to errors, thus guidelines for safe use of medications in geriatrics should be strictly implemented to prevent medication errors. Antimicrobials are the major class of drugs involved in medication errors, thus this study recommends strict implementations of antibiotic policy in the hospital.
本研究旨在评估一家三级医院普通内科用药错误的发生率，并对用药错误进行分类。因此，本研究旨在通过有效利用临床药师来提高用药安全性，并确保医疗服务质量。研究目的是检测和分类用药错误，确保医院合理用药，为医生、护士和患者提出建议以促进安全用药。
本研究在印度南部一家拥有350张床位的多专科三级转诊医院的普通内科住院患者中进行。这是一项前瞻性观察性研究，使用数据收集表收集数据，该表包括患者人口统计学细节、药物细节以及错误识别标准、分类和涉及错误的药物细节。通过查阅用药记录、审查处方、走访护理站和药房以及与患者和旁观者进行个人访谈，记录患者和药物的完整细节。然后对收集到的细节进行评估，以检测处方、给药、调配错误和药物相互作用，然后进行记录，并提出预防所报告用药错误再次发生的必要措施。
本研究共纳入311例患者，其中男性168例（54%），女性143例（46%）。在311例病例中，36例（11.57%）至少有一处错误。发现的错误总数为67处，其中给药错误（28.35%）是最常见的错误类型，其次是处方错误（22.38%）、调配错误（8.9%），药物相互作用、患者错误和其他类型的错误合计占其余部分。共为106例患者开具了2742种药物，每位患者的平均用药数为8.8种。特定药物类别与用药错误的关联表明，抗菌药物的贡献最大（26.8%），其次是心血管药物（20.8%）。排在第三位的是非甾体抗炎药（11.9%），紧随其后的是中枢神经系统药物和胃肠道药物（7.4%）。药物相互作用的总百分比为40.29%。大多数相互作用为中度类型，属于用药错误的C类。
本研究有助于评估用药错误的发生率并对用药错误进行分类。在普通内科，大多数患者为老年人，更容易出现错误，因此应严格执行老年患者安全用药指南以预防用药错误。抗菌药物是涉及用药错误的主要药物类别，因此本研究建议在医院严格执行抗生素政策。
