Kamboj Amrit K, Spiller Henry A, Casavant Marcel J, Hodges Nichole L, Chounthirath Thiphalak, Smith Gary A
1 Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
2 Mayo Clinic, Rochester, MN, USA.
Ann Pharmacother. 2017 Oct;51(10):825-833. doi: 10.1177/1060028017714271. Epub 2017 Jun 13.
Prior studies have not examined national trends and characteristics of unintentional non-health care facility (HCF) medication errors associated with cardiovascular drugs.
To investigate non-HCF medication errors associated with cardiovascular drugs reported to poison control centers in the United States.
A retrospective analysis of non-HCF medication errors associated with cardiovascular drugs from 2000 to 2012 was conducted using the National Poison Data System database.
There were 278 444 medication errors associated with cardiovascular drugs reported to US poison control centers during the study period, averaging 21 419 exposures annually. The overall rate of cardiovascular medication errors per 100 000 population increased 104.6% from 2000 to 2012 ( P < 0.001) and the highest rates were among older adults. Most cases (83.6%) did not require treatment at a HCF. Serious medical outcomes were reported in 4.0% of exposures. The cardiovascular drugs most commonly implicated in medication errors were β-blockers (28.2%), calcium antagonists (17.7%), and angiotensin-converting enzyme inhibitors (15.9%). Most of the 114 deaths were associated with cardiac glycosides (47.4%) or calcium antagonists (29.8%). Most medication errors involved taking or being given a medication twice (52.6%).
This study describes characteristics and trends of non-HCF cardiovascular medication errors over a 13-year period in the United States. The number and rate of cardiovascular medication errors increased steadily from 2000 to 2012, with the highest error rates among older adults. Further research is needed to identify prevention strategies for these errors, with a particular focus on the older adult population.
既往研究未探讨与心血管药物相关的非医疗保健机构（HCF）非故意用药错误的全国趋势和特征。
调查向美国中毒控制中心报告的与心血管药物相关的非HCF用药错误。
利用国家中毒数据系统数据库对2000年至2012年期间与心血管药物相关的非HCF用药错误进行回顾性分析。
在研究期间，美国中毒控制中心共报告了278444例与心血管药物相关的用药错误，每年平均有21419例暴露。每10万人口中心血管药物用药错误的总体发生率从2000年到2012年增加了104.6%（P<0.001），最高发生率出现在老年人中。大多数病例（83.6%）不需要在医疗保健机构接受治疗。4.0%的暴露报告了严重的医疗后果。用药错误中最常涉及的心血管药物是β受体阻滞剂（28.2%）、钙拮抗剂（17.7%）和血管紧张素转换酶抑制剂（15.9%）。114例死亡中大多数与强心苷（47.4%）或钙拮抗剂（29.8%）有关。大多数用药错误涉及重复用药（52.6%）。
本研究描述了美国13年间非HCF心血管用药错误的特征和趋势。从2000年到2012年，心血管用药错误的数量和发生率稳步上升，老年人中的错误率最高。需要进一步研究以确定这些错误的预防策略，尤其要关注老年人群体。
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