Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA.
Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA.
Lancet Oncol. 2018 Apr;19(4):e191-e199. doi: 10.1016/S1470-2045(18)30094-9.
Although chemotherapy is a well established treatment modality, chemotherapy errors represent a potentially serious risk of patient harm. We reviewed published research from 1980 to 2017 to understand the extent and nature of medication errors in cancer chemotherapy, and to identify effective interventions to help prevent mistakes. Chemotherapy errors occur at a rate of about one to four per 1000 orders, affect at least 1-3% of adult and paediatric oncology patients, and occur at all stages of the medication use process. Oral chemotherapy use is a particular area of growing risk. Our knowledge of chemotherapy errors is drawn primarily from single-institution studies at university hospitals and referral centres, with a particular focus on prescription orders and pharmacy practices. Although the heterogeneity of research methods and measures used in these studies limits our understanding of this issue, the rate of chemotherapy error-related injuries is generally lower than those seen in comparable studies of general medical patients. Although many interventions show promise in reducing chemotherapy errors, most have little empirical support. Additional research is needed to understand and to mitigate the risk of chemotherapy medication errors.
虽然化疗是一种成熟的治疗方式，但化疗错误可能对患者造成严重伤害。我们回顾了 1980 年至 2017 年发表的研究，以了解癌症化疗中药物错误的程度和性质，并确定有助于预防错误的有效干预措施。化疗错误的发生率约为每 1000 个医嘱 1 到 4 个，至少影响 1-3%的成人和儿科肿瘤患者，并且发生在用药过程的各个阶段。口服化疗的使用是一个风险日益增加的特定领域。我们对化疗错误的认识主要来自于大学医院和转诊中心的单机构研究，特别关注处方医嘱和药房实践。尽管这些研究中使用的研究方法和措施的异质性限制了我们对这一问题的理解，但与一般医疗患者的可比研究相比，化疗相关伤害的发生率通常较低。尽管许多干预措施在减少化疗错误方面显示出前景，但大多数都没有多少经验证据支持。需要进一步的研究来了解和减轻化疗药物错误的风险。
