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社区药房预防涉及新冠病毒疾病患者处方错误的新策略评估

Assessment of A new Strategy to Prevent Prescribing Errors Involving COVID-19 Patients in Community Pharmacies.

作者信息

Abdel-Qader Derar H, Al Meslamani Ahmad Z, Albassam Abdullah, Al Mazrouei Nadia, El-Shara Asma A, El Sharu Husam, Ebaed Samah Bahy Mohammed, Ibrahim Osama Mohamed

机构信息

University of Petra, Amman, Jordan.

AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates.

出版信息

Hosp Pharm. 2022 Oct;57(5):654-665. doi: 10.1177/00185787211073506. Epub 2022 Apr 4.

Abstract

Because COVID-19 patients are vulnerable to prescribing errors (PEs) and adverse drug events, designing and implementing a new approach to prevent prescribing errors (PEs) involving COVID-19 patients has become a priority in pharmacotherapy research. To investigate whether using WhatsApp to deliver prescribing error (PE)-related clinical scenarios to community pharmacists could enhance their ability to detect PEs and conduct successful pharmaceutical interventions (PIs). In this study, 110 community pharmacies were recruited from different regions across Jordan and equally allocated to 2 groups. Over the course of 4 weeks, WhatsApp was used to send PEs-related clinical case scenarios to the active group. The second group was controlled with no clinical scenarios. After completion of the 4-week phase, pharmacists from both groups were asked to document PEs in COVID-19 patients and their interventions using a data-collection form. The incidence of PEs in COVID-19 patients documented in the active group (18.54%) was higher than that reported in the control group (3.09%) ( = .001). Of the 6598 and 968 PIs conducted by participants working in the active and control group pharmacies, 6013 (91.13%) and 651 (67.25%) were accepted, respectively. The proportions of wrong drug (contraindication), wrong drug (unnecessary drug prescribed/no proof of its benefits), and omission of a drug between the active and control groups were 15.30% versus 7.21% ( = .001), 11.85% versus 6.29% ( = .03), and 17.78% versus 10.50% (0.01), respectively. Additionally, the proportions of lethal, serious, and significant errors were 0.74% versus 0.35% ( = .04), 10.52% versus 2.57% (0.002), and 47.88% versus 9.57% (0.001), respectively. Addition of drug therapy interventions (AOR = 0.62; 95% CI, 0.21-0.84) and errors with significant clinical seriousness (AOR = 0.32; 95% CI, 0.16-0.64). Conclusions PEs involving COVID-19 patients in community settings are common and clinically significant. The intervention assessed in this study could be promising for designing a feasible and time-efficient interventional tool to encourage pharmacists' involvement in identifying and correcting PEs in light of COVID-19.

摘要

由于新冠病毒病(COVID-19)患者容易出现处方错误(PEs)和药物不良事件,因此设计并实施一种新方法以预防涉及COVID-19患者的处方错误已成为药物治疗研究的当务之急。旨在调查使用WhatsApp向社区药剂师提供与处方错误(PE)相关的临床场景是否可以提高他们检测PEs并进行成功药物干预(PIs)的能力。在本研究中,从约旦不同地区招募了110家社区药房,并将其平均分为2组。在4周的时间里,使用WhatsApp向活跃组发送与PEs相关的临床病例场景。第二组作为对照组,不提供临床场景。在4周阶段结束后,要求两组药剂师使用数据收集表记录COVID-19患者的PEs及其干预措施。活跃组记录的COVID-19患者中PEs的发生率(18.54%)高于对照组报告的发生率(3.09%)(P = 0.001)。活跃组和对照组药房的参与者分别进行了6598次和968次药物干预(PIs),其中分别有6013次(91.13%)和651次(67.25%)被接受。活跃组和对照组之间错误用药(禁忌症)、错误用药(开具不必要药物/无益处证明)和漏用药物的比例分别为15.30%对7.21%(P = 0.001)、11.85%对6.29%(P = 0.03)和17.78%对10.50%(P = 0.01)。此外,致命、严重和重大错误的比例分别为0.74%对0.35%(P = 0.04)、10.52%对2.57%(P = 0.002)和47.88%对9.57%(P = 0.001)。增加药物治疗干预(调整后比值比[AOR] = 0.62;95%置信区间[CI],0.21 - 0.84)以及具有重大临床严重性的错误(AOR = 0.32;95% CI,0.16 - 0.64)。结论社区环境中涉及COVID-19患者的PEs很常见且具有临床意义。本研究中评估的干预措施对于设计一种可行且高效的干预工具可能很有前景,以鼓励药剂师参与识别和纠正COVID-19相关的PEs。

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