Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
World Health Organization, Geneva, Switzerland.
J Glob Health. 2019 Jun;9(1):010422. doi: 10.7189/jogh.09.010422.
Medication errors continue to contribute substantially to global morbidity and mortality. In the context of the recent launch of the World Health Organization's (WHO) Third Global Patient Safety Challenge: , we sought to establish agreement on research priorities for medication safety.
We undertook a consensus prioritisation exercise using an approach developed by the Child Health and Nutrition Research Initiative. Based on a combination of productivity and citations, we identified leading researchers in patient and medication safety and invited them to participate. We also extended the invitation to a further pool of experts from the WHO Global Patient Safety Network. All experts independently generated research ideas, which they then independently scored based on the criteria of: answerability, effectiveness, innovativeness, implementation, burden reduction and equity. An overall Research Priority Score and Average Expert Agreement were calculated for each research question.
131 experts submitted 333 research ideas, and 42 experts then scored the proposed research questions. The top prioritised research areas were: (1) deploying and scaling technology to enhance medication safety; (2) developing guidelines and standard operating procedures for high-risk patients, medications and contexts; (3) score-based approaches to predicting high-risk patients and situations; (4) interventions to increase patient medication literacy; (5) focused training courses for health professionals; and (6) universally applicable pictograms to avoid medication-related harm. Whilst there was a focus on promoting patient education and involvement across resource settings, priorities identified in high-resource settings centred on the optimisation of existing systems through technology. In low- and middle-resource settings, priorities focused on identifying systemic issues contributing to high-risk situations.
WHO now plans to work with global, regional and national research funding agencies to catalyse the investment needed to enable teams to pursue these research priorities in medication safety across high-, middle- and low-resource country settings.
药物错误继续对全球发病率和死亡率造成重大影响。在世界卫生组织（世卫组织）启动第三个全球患者安全挑战的背景下： ，我们试图就药物安全的研究重点达成共识。
我们使用儿童健康与营养研究倡议制定的方法进行了共识优先排序工作。根据生产力和引文的结合，我们确定了在患者和药物安全方面的领先研究人员，并邀请他们参加。我们还向世卫组织全球患者安全网络的另一批专家发出了邀请。所有专家都独立提出了研究想法，然后根据以下标准对这些想法进行独立评分：可回答性、有效性、创新性、实施、负担减轻和公平性。为每个研究问题计算了总体研究重点得分和平均专家一致性。
131 名专家提交了 333 个研究想法，然后 42 名专家对提出的研究问题进行了评分。优先考虑的研究领域包括：（1）部署和扩大技术以增强药物安全性；（2）为高风险患者、药物和环境制定指南和标准操作程序；（3）基于评分的方法预测高风险患者和情况；（4）提高患者药物知识的干预措施；（5）针对卫生专业人员的重点培训课程；（6）通用的象形图以避免与药物相关的伤害。尽管重点是在各种资源环境中促进患者教育和参与，但在高资源环境中确定的优先事项侧重于通过技术优化现有系统。在中低收入国家，重点是确定导致高风险情况的系统性问题。
世卫组织现在计划与全球、区域和国家研究资助机构合作，促进投资，使各团队能够在高、中、低收入国家环境中针对药物安全的这些研究重点开展工作。
