Magal Pranav, Spiller Henry A, Casavant Marcel J, Chounthirath Thitphalak, Michaels Nichole L, Smith Gary A
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
Northeast Ohio Medical University, Rootstown, OH, USA.
J Med Toxicol. 2017 Dec;13(4):293-302. doi: 10.1007/s13181-017-0630-8. Epub 2017 Sep 13.
Hormones and hormone antagonists are frequently associated with medication errors and may result in important adverse outcomes. The purpose of this study is to investigate non-health care facility (non-HCF) medication errors associated with hormones and hormone antagonists in the United States (US).
A retrospective analysis of National Poison Data System data was conducted to identify characteristics and trends of unintentional non-HCF therapeutic errors involving hormones and hormone antagonists among individuals of all ages from 2000 to 2012.
From 2000 to 2012, US poison control centers received 169,695 calls regarding unintentional non-HCF therapeutic errors associated with hormone therapies, averaging 13,053 medication error calls annually. The rate of reported errors increased significantly by 162.6% (p < 0.001), from 2.24 per 100,000 US residents in 2000 to 5.89 per 100,000 in 2012. Two thirds of the errors (65.2%) occurred among females. The medications most commonly associated with errors were thyroid preparations (23.2%), corticosteroids (21.9%), and insulin (20.0%). All nine deaths and 93.2% of major effects were attributed to hypoglycemic agents. Sulfonylureas alone accounted 43.9% of major effects. The number and rate of therapeutic errors increased significantly for all medication categories except estrogen and thiazolidinediones. Most errors were managed at the site of exposure (82.9%) and did not result in serious medical outcomes (95.6%).
This study provides an overview of non-HCF medication errors associated with hormones and hormone antagonists in the US. While most errors did not result in adverse outcomes, their increasing frequency places a greater burden on the health care system.
激素和激素拮抗剂经常与用药错误相关联,并可能导致严重的不良后果。本研究的目的是调查美国非医疗机构(non-HCF)中与激素和激素拮抗剂相关的用药错误。
对国家毒物数据系统的数据进行回顾性分析,以确定2000年至2012年所有年龄段个体中涉及激素和激素拮抗剂的非故意非医疗机构治疗错误的特征和趋势。
2000年至2012年,美国毒物控制中心接到169,695个关于与激素疗法相关的非故意非医疗机构治疗错误的电话,每年平均有13,053个用药错误电话。报告的错误率显著增加了162.6%(p < 0.001),从2000年每10万美国居民中的2.24例增加到2012年的每10万居民中的5.89例。三分之二的错误(65.2%)发生在女性中。与错误最常相关的药物是甲状腺制剂(23.2%)、皮质类固醇(21.9%)和胰岛素(20.0%)。所有9例死亡和93.2%的主要后果都归因于降糖药。仅磺脲类药物就占主要后果的43.9%。除雌激素和噻唑烷二酮类药物外,所有药物类别的治疗错误数量和发生率均显著增加。大多数错误在接触现场得到处理(82.9%),并未导致严重的医疗后果(95.6%)。
本研究概述了美国非医疗机构中与激素和激素拮抗剂相关的用药错误。虽然大多数错误没有导致不良后果,但它们频率的增加给医疗系统带来了更大的负担。