Mansouri Ava, Ahmadvand Alireza, Hadjibabaie Molouk, Javadi Mohammadreza, Khoee Seyed Hamid, Dastan Farzaneh, Gholami Kheirollah
Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Pharm Res. 2014 Winter;13(1):3-17.
Medication error (ME) is the most common preventable cause of adverse drug events which negatively affects patient safety. Inadequate, low-quality studies plus wide estimation variations in ME from developing countries including Iran, decreases the reliability of ME evaluations. To clarify sources, underreporting reasons and preventive measures of MEs, we reviewed Iran current available literature. We searched Scopus, WOS, PubMed, CINAHL, EBSCOHOST and Persian databases (IranMedex, and SID) up to October 2012. Two authors independently selected and one reviewed and extracted data. Results reported by more than 30% of studies considered as the most important topics. Finally 25 articles were included. All study designs were cross-sectional (except for two interventional studies) and in hospital settings. Nursing staff and students were the most observed populations. Individual factor, with "inadequate knowledge of medication" as its most frequent reason, were the mostly reported source of MEs. Fear and reporting process were two most important reporting barriers. The sense of being reprimanded and ignoring to report respectively were their most frequent factors. Anti-infectives were the most frequent drugs involved in MEs. Preventive measures were varied and reporting of their effectiveness was inconsistent. There are still many research gaps which need to be explored by further studies. Based on our findings, further researches may be focused on design, implementation, and evaluation of a ME reporting system as groundwork, assessing systems-related factors to ME alongside individual factors and evaluating the effectiveness of preventive measures for MEs in trials.
用药差错(ME)是不良药物事件最常见的可预防原因,对患者安全产生负面影响。包括伊朗在内的发展中国家,关于用药差错的研究不足、质量不高,且估计差异很大,这降低了用药差错评估的可靠性。为了阐明用药差错的来源、漏报原因和预防措施,我们查阅了伊朗现有的文献。截至2012年10月,我们检索了Scopus、WOS、PubMed、CINAHL、EBSCOHOST和波斯语数据库(IranMedex和SID)。两位作者独立筛选,一位作者进行文献回顾和数据提取。超过30%的研究所报告的结果被视为最重要的主题。最终纳入了25篇文章。所有研究设计均为横断面研究(两项干预性研究除外),且均在医院环境中进行。护理人员和学生是观察最多的人群。个体因素是用药差错最主要的报告来源,其中“用药知识不足”是最常见的原因。恐惧和报告流程是两个最重要的报告障碍。最常见的因素分别是被斥责的感觉和不报的行为。抗感染药物是用药差错中最常涉及的药物。预防措施多种多样,且其有效性的报告并不一致。仍有许多研究空白需要进一步研究探索。根据我们的研究结果,进一步的研究可能集中在作为基础工作的用药差错报告系统的设计、实施和评估,评估与用药差错相关的系统因素以及个体因素,并在试验中评估用药差错预防措施的有效性。