a Department of Medicine , University Hospitals Birmingham NHS Foundation Trust , Birmingham , UK.
b Institute of Clinical Sciences, College of Medical and Dental Sciences , University of Birmingham , Birmingham , UK.
Expert Opin Drug Saf. 2019 Feb;18(2):69-74. doi: 10.1080/14740338.2019.1571038. Epub 2019 Jan 28.
Unintended harm from prescribing errors remains a prevalent concern in healthcare leading to significant morbidity and mortality around the world. Prescribers face new challenges to their practice in modern times such as increasingly complex health-care systems, an aging population with increasing multimorbidity, and rapid growth in the number of novel medicines. Areas covered: Prescribing concerns in modern practice are outlined based on seminal literature in this area and the author's continual academic oversight of this topic. Major UK and international reports have been used to highlight the important emerging issues in prescribing, and focused literature searches performed to highlight key papers supporting this review. Expert opinion: Whilst there are many ways to consider mitigating the risk of harm from prescribing, it is suggested that a tripartite approach is required. Patients and carers are essential partners in the process and shared decision-making has replaced paternalistic practice in achieving joint prescribing decisions. Comprehensive and coordinated care is critical to avoid fragmented care and poor transfer of prescribing information. Lastly, a whole systems approach is crucial to ensure that all prescribers are supported (and not overwhelmed) when making safe, effective and timely prescribing decisions.
在医疗保健领域，由于处方错误而导致的非预期伤害仍然是一个普遍存在的问题，在全球范围内导致了大量的发病率和死亡率。在现代，开处方者面临着新的挑战，如日益复杂的医疗保健系统、患有多种疾病的老龄化人口增加，以及新型药物数量的快速增长。涵盖领域：根据该领域的开创性文献和作者对该主题的持续学术监督，概述了现代实践中的处方问题。主要的英国和国际报告被用来强调处方方面的重要新问题，并进行了重点文献检索，以强调支持本综述的关键论文。专家意见：虽然有很多方法可以考虑减轻处方风险造成的伤害，但建议需要采用三方方法。患者和护理人员是该过程的重要合作伙伴，共同决策已经取代了家长式的做法，以达成共同的处方决策。全面协调的护理对于避免护理碎片化和处方信息传递不良至关重要。最后，整个系统的方法至关重要，以确保所有的开处方者在做出安全、有效和及时的处方决策时都得到支持（而不是不知所措）。
