Hu Qinyuan, Hu Haiyao, Hu Ming, Zhang Jun, Gou Liangwen, Shi Shuping, Zhou Jingyi, Zhou Naitong, Huang Zhen
Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry and Sichuan Province, Sichuan Engineering Laboratory for Plant-Sourced Drug and Sichuan Research Center for Drug Precision Industrial Technology, West China School of Pharmacy, Sichuan University, Chengdu, China.
Administration for Market Regulation of Qionglai, Chengdu, China.
Front Med (Lausanne). 2022 Jul 19;9:913214. doi: 10.3389/fmed.2022.913214. eCollection 2022.
Online pharmacies have gradually penetrated the market, but pose risks to patients' health. Failure Mode and Effect Analysis (FMEA) is an effective and reliable method for reducing pharmacy and medication risks. The purpose of this study was to conduct a prospective risk analysis of the process of purchasing prescription drugs from online pharmacies in China to guarantee drug quality and patient safety.
The FMEA was performed at Sichuan University, China. A multidisciplinary team was assembled comprising a leader, four regulators, four pharmacists, two experts, etc. The process was composed of eight subprocesses: searching for prescription drugs, submitting medication requirements, completing patient information forms, dispensing, delivering, etc. Brainstorming was used to identify and prioritize failure modes, propose corrective actions, and reduce risks. Risk priority numbers were the main criterion and were obtained by multiplying three scores: severity, occurrence and detectability, which were scored by the team The team proposed corrective actions for each selected failure mode.
A total of forty-one potential failure modes were identified, and the causes, effects, and corrective actions of the 30 top failure modes were analyzed. The highest risk value was assigned to "photocopies of paper prescriptions uploaded were reused by patients." Three failure modes for the S value of 5 were: "drugs are eroded and polluted by moisture or insects in the process of transportation," "the qualification information of the pharmacies were absent or fake," and "pharmacists fail to check prescriptions in accordance with Prescription Administrative Regulation." Of the top failure modes, 36.67% were from Step 5, delivering the drug. After taking corrective measures to control risks, the risks reduced by 69.26%.
The results of this study proves that the FMEA is a valuable tool for identifying and prioritizing the risks inherent in online pharmacies. This study shows that there are many potential risks in the process of purchasing prescription drugs from online pharmacies, especially in the drug delivery stage. Enhanced training and the introduction of smart devices may minimize risks. Online pharmacies and Chinese regulators should consider these findings for risk mitigation and the improvement of regulations pertaining to online pharmacies.
在线药房已逐渐渗透市场,但对患者健康构成风险。失效模式与效应分析(FMEA)是降低药房和用药风险的一种有效且可靠的方法。本研究的目的是对在中国从在线药房购买处方药的过程进行前瞻性风险分析,以确保药品质量和患者安全。
在中国四川大学进行FMEA。组建了一个多学科团队,包括一名负责人、四名监管人员、四名药剂师、两名专家等。该过程由八个子过程组成:搜索处方药、提交用药需求、填写患者信息表、配药、送货等。通过头脑风暴来识别失效模式并确定其优先级,提出纠正措施并降低风险。风险优先数是主要标准,通过将严重度、发生度和可探测度三个分数相乘获得,由团队进行评分。团队针对每个选定的失效模式提出纠正措施。
共识别出41种潜在失效模式,并分析了30种主要失效模式的原因、影响和纠正措施。风险值最高的是“患者重复使用上传的纸质处方复印件”。严重度(S)值为5的三种失效模式分别是:“药品在运输过程中被水分或昆虫侵蚀和污染”、“药房资质信息缺失或造假”、“药剂师未按照《处方管理办法》审核处方”。在主要失效模式中,36.67%来自第5步,即药品配送。采取纠正措施控制风险后,风险降低了69.26%。
本研究结果证明FMEA是识别在线药房固有风险并确定其优先级的有价值工具。本研究表明,从在线药房购买处方药的过程中存在许多潜在风险,尤其是在药品配送阶段。加强培训和引入智能设备可能会将风险降至最低。在线药房和中国监管机构应考虑这些研究结果以减轻风险并完善与在线药房相关的法规。