College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
Int J Clin Pharm. 2020 Aug;42(4):979-994. doi: 10.1007/s11096-020-01034-z. Epub 2020 Apr 24.
Background Medication errors are avoidable events that may occur at any stage of the medication use process. Implementing a clinical pharmacist is one strategy that is believed to reduce the number of medication errors. Pediatric patients, who are more vulnerable to medication errors due to several contributing factors, may benefit from the interventions of a pharmacist. Aim of the review To qualitatively and quantitatively evaluate the impact of clinical pharmacist interventions on medication error rates for hospitalized pediatric patients. Methods PubMed, EMBASE, Cochrane Controlled Trials Register and Google Scholar search engines were searched from database inception to February 2020. Study selection, data extraction and quality assessment was conducted by two independent reviewers. Observational and interventional studies were included. Data extraction was done manually and the Crowe Critical Appraisal Tool was used to critically appraise eligible articles. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model for rates of medication errors. Results 19 studies were systematically reviewed and 6 studies (29,291 patients) were included in the meta-analysis. Pharmacist interventions involved delivering educational sessions, reviewing prescriptions, attending rounds and implementing a unit-based clinical pharmacist. The systematic review indicated that the most common trigger for pharmacist interventions was inappropriate dosing. Pharmacist involvement was associated with significant reductions in the overall rate of medication errors occurrence (OR 0.27; 95% CI 0.15 to 0.49). Conclusion Pharmacist interventions are effective for reducing medication error rates in hospitalized pediatric patients.
背景
药物错误是可在药物使用过程的任何阶段发生的可避免事件。实施临床药师是被认为可以减少药物错误数量的策略之一。由于多种因素的影响,儿科患者更容易发生药物错误,因此他们可能受益于药师的干预。
目的
定性和定量评估临床药师干预对住院儿科患者药物错误率的影响。
方法
从数据库建立到 2020 年 2 月,我们在 PubMed、EMBASE、Cochrane 对照试验登记处和 Google Scholar 搜索引擎中进行了搜索。两名独立评审员进行了研究选择、数据提取和质量评估。纳入观察性和干预性研究。手动进行数据提取,并使用 Crowe 批判性评估工具对合格文章进行批判性评估。使用随机效应模型计算药物错误发生率的比值比(OR)及其 95%置信区间(CI)。
结果
系统综述了 19 项研究,其中 6 项研究(29,291 名患者)纳入荟萃分析。药师干预包括提供教育课程、审查处方、参加查房和实施基于单位的临床药师。系统评价表明,药师干预最常见的触发因素是剂量不当。药师参与与药物错误总发生率的显著降低相关(OR 0.27;95%CI 0.15 至 0.49)。
结论
药师干预可有效降低住院儿科患者的药物错误率。