a Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco , "Luigi Sacco" University Hospital, Università di Milano , Milan , Italy.
b Scientific Institute IRCCS Eugenio Medea , Lecco , Italy.
Expert Opin Drug Saf. 2018 Dec;17(12):1161-1169. doi: 10.1080/14740338.2018.1550069. Epub 2018 Nov 27.
To characterize adverse reactions associated with medication errors (ME) reported in US Food and Drug Administration Adverse Event Reporting System (US-FAERS), and to identify the potential signals of disproportionate reporting (SDR) for different drugs.
ME associated Individual Case Study Report (ICSRs) were identified. ICSRs were categorized by patient age groups, affected stages of medication process and Anatomical Therapeutic Chemical classification system. Disproportionality analyses were performed for different age groups.
46,8677 ICSRs were retrieved. An increasing trend in reporting of cases of ME was observed during the studied period. Immunosuppressants and psycholeptic drugs were most frequently involved. Administration errors were reported most frequently, followed by prescribing and dispensing errors. In neonates, SDR following wrong drug administration, wrong dose, and accidental overdose were associated with methylergonovine, zidovudine, and acetaminophen. In elderlies, SDR were found for dose omission and underdose error associated with etanercept and evolocumab.
While a detailed root-cause analysis for ME characteristic can rarely be performed on such a dataset, data mining for signals in spontaneous reporting database may assist in identifying potential ME in a more standardized and objective manner. Continued use of spontaneous reporting system for identifying MEs is encouraged to prevent unnecessary patient harm.
描述美国食品和药物管理局不良事件报告系统(US-FAERS)中报告的与用药错误(ME)相关的不良反应,并确定不同药物潜在的不适当报告信号(SDR)。
确定与 ME 相关的个体病例研究报告(ICSR)。根据患者年龄组、受影响的用药过程阶段和解剖治疗化学分类系统对 ICSR 进行分类。对不同年龄组进行了比例失调分析。
共检索到 468677 份 ICSR。在研究期间,ME 病例报告的报告呈上升趋势。免疫抑制剂和精神药物最常涉及。报告的给药错误最频繁,其次是处方和配药错误。在新生儿中,与错误的药物管理、错误的剂量和意外过量相关的 SDR 与甲基麦角新碱、齐多夫定和对乙酰氨基酚有关。在老年人中,与依那西普和依洛尤单抗相关的剂量遗漏和剂量不足错误存在 SDR。
虽然在这样的数据集中很少能对 ME 特征进行详细的根本原因分析,但在自发报告数据库中进行信号挖掘可能有助于以更标准化和客观的方式识别潜在的 ME。鼓励继续使用自发报告系统来识别 ME,以防止不必要的患者伤害。