Department of Pharmacy and Pharmaceutical Sciences, Faculty of Allied Health Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka.
PLoS One. 2020 Jun 4;15(6):e0233486. doi: 10.1371/journal.pone.0233486. eCollection 2020.
Most residents in elderly care homes in Sri Lanka do not receive formal, on-site, patient care services.
To evaluate the appropriateness of prescribing, dispensing, administration, and storage practices of medication used by residents in selected elderly care homes in Colombo District, Sri Lanka.
This was a prospective, cross-sectional, multi-center study of 100 residents with chronic, non-communicable diseases, who resided in nine selected elderly care homes in Sri Lanka. Medication histories were obtained from each resident/caregiver and the appropriateness of medications in their current prescription was reviewed using standard treatment guidelines. Prescriptions were cross-checked against respective dispensing labels to identify dispensing errors. Medication administration was directly observed on two separate occasions per resident for accuracy of administration, and matched against the relevant prescription instructions. Medication storage was also observed in terms of exposure to temperature and sunlight, the suitability of container, and adequacy of separation if using multiple medications.
The mean age of residents was 70±10.5 years and the majority were women (72%). A total of 168 errors out of 446 prescriptions were identified. The mean number of prescribing errors per resident was 1.68±1.23 [median, 2.00 (1.00-3.00)]. Inappropriate dosing frequencies were the highest (37.5%;63/168), followed by missing or inappropriate medications (31.5%;53/168). The mean number of dispensing errors per resident was 15.9±13.1 [median, 14.0 (6.00-22.75)] with 3.6 dispensing errors per every medication dispensed. Mean administration errors per resident was 0.95±1.5 [median, 0.00 (0.00-1.00)], with medication omissions being the predominant error (50.5%;48/95). Another lapse was incorrect storage of medications (143 storage errors), and included 83 medications not properly separated from each other (58.0%).
Multiple errors related to prescribing, dispensing, administration, and storage were identified amongst those using medication in elderly care homes. Services of a dedicated consultant pharmacist could improve the quality of medication use in elderly care homes in Sri Lanka.
斯里兰卡大多数养老院的居民无法获得正规的现场病人护理服务。
评估在斯里兰卡科伦坡地区选定的养老院中，居民使用的药物的处方、配药、给药和储存实践是否恰当。
这是一项针对 100 名患有慢性非传染性疾病的居民的前瞻性、横断面、多中心研究，这些居民居住在斯里兰卡的 9 家选定的养老院中。从每位居民/护理人员那里获取药物使用史，并使用标准治疗指南审查当前处方中药物的适当性。将处方与各自的配药标签进行核对，以识别配药错误。对每位居民进行两次独立的药物管理观察，以评估给药的准确性，并与相关的处方说明进行核对。还观察了药物储存情况，包括药物是否暴露于温度和阳光、容器是否合适以及是否使用多个药物进行了充分的分隔。
居民的平均年龄为 70±10.5 岁，大多数为女性（72%）。在 446 张处方中发现了 168 个错误。每位居民的平均处方错误数为 1.68±1.23[中位数，2.00（1.00-3.00）]。不合适的给药频率最高（37.5%；63/168），其次是缺药或用药不当（31.5%；53/168）。每位居民的平均配药错误数为 15.9±13.1[中位数，14.0（6.00-22.75）]，每配一种药就有 3.6 个配药错误。每位居民的平均给药错误数为 0.95±1.5[中位数，0.00（0.00-1.00）]，给药遗漏是主要错误（50.5%；48/95）。另一个失误是药物储存不当（143 个储存错误），包括 83 种药物未妥善分开（58.0%）。
在养老院使用药物的居民中，发现了与处方、配药、给药和储存相关的多种错误。一名专职顾问药剂师的服务可以提高斯里兰卡养老院的药物使用质量。
