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国家基本解毒药物清单专家共识:E-Delphi 法。

Expert consensus for a national essential antidote list: E-Delphi method.

机构信息

Department of Pharmacy Practice, College of Pharmacy, Kuwait University, Jabriya, Kuwait.

Pharmacist, Ministry of Health, Kuwait, Kuwait.

出版信息

PLoS One. 2022 Jun 16;17(6):e0269456. doi: 10.1371/journal.pone.0269456. eCollection 2022.

Abstract

Antidote stocking represents a major challenge to hospitals all over the world, including Kuwait. In order to assist hospitals to reduce costs and improve patient care, an essential antidote list can be used as an initial foundation for securing sufficient antidote availability at healthcare institutions. The aim of our study is to generate a nationally relevant essential antidote list for emergency care hospitals in Kuwait using the e-Delphi method by establishing consensus through a multidisciplinary expert group of healthcare providers. An electronic survey with 47 essential antidotes was developed. The e-Delphi method was used, with three rounds of voting, to determine expert consensus on an essential antidote list for hospitals in Kuwait. A purposive sample of healthcare professionals from governmental and private hospitals were selected for this study (n = 30). Consensus was gained if ≥75% of the expert panel agreed on the inclusion of the antidote, without any strong disagreements. Round 1 of the e-Delphi resulted in 41 antidotes reaching consensus and seven new antidotes suggested by the expert panel. Round 2 had two antidotes (out of seven newly suggested ones) reaching consensus. Round 3 was a confirmatory round, where the expert group agreed on their previous rounds' opinions. This resulted in the development of an essential antidote list with 43 antidotes. The optimal approach for ensuring adequate availability of antidotes is continuous monitoring of local poisoning incidence and antidote requirements through collaborations between academic researchers and emergency care clinicians. The development of an essential antidote list, with expert consensus, is one of the initial steps in securing a foundation for appropriate provision of antidotes at all healthcare institutions. This is the first study that the authors are aware of that demonstrates that the e-Delphi technique can consolidate recommendations of experts in emergency medicine to provide a list of essential antidotes.

摘要

解毒剂库存是全世界,包括科威特的医院面临的主要挑战。为了帮助医院降低成本并改善患者护理,一份基本解毒剂清单可以作为在医疗机构确保充足解毒剂供应的初步基础。我们的研究旨在使用电子德尔菲法通过建立一个由医疗保健提供者组成的多学科专家组来达成共识,为科威特的急救医院生成一份具有国家相关性的基本解毒剂清单。开发了一份包含 47 种基本解毒剂的电子调查。使用电子德尔菲法进行了三轮投票,以确定科威特医院基本解毒剂清单的专家共识。本研究选择了来自政府和私营医院的医疗保健专业人员进行了一项目的抽样调查(n=30)。如果≥75%的专家小组同意解毒剂的纳入,且没有强烈的分歧,则达成共识。电子德尔菲法第一轮达成共识的解毒剂有 41 种,专家组建议新增的解毒剂有 7 种。第二轮有两种解毒剂(专家组新建议的七种解毒剂中的两种)达成共识。第三轮是确认轮,专家组对前两轮的意见表示同意。由此制定了一份基本解毒剂清单,其中包含 43 种解毒剂。确保解毒剂充足供应的最佳方法是通过学术研究人员和急救临床医生之间的合作,持续监测当地中毒发生率和解毒剂需求。通过专家共识制定基本解毒剂清单是确保所有医疗机构提供适当解毒剂的基础的初始步骤之一。这是作者所知的第一项表明电子德尔菲技术可以整合急诊医学专家建议以提供基本解毒剂清单的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2091/9202922/3899c3c59a52/pone.0269456.g001.jpg

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