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患者种族/民族、健康素养、社会经济地位与用药错误发生率之间的关联:一项系统综述

Association Between Patient Race/Ethnicity, Health Literacy, Socio-Economic Status, and Incidence of Medication Errors: A Systematic Review.

作者信息

Suen Kelly, Shrestha Sunil, Osman Samira, Paudyal Vibhu

机构信息

School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.

Department of Research and Academics, Kathmandu Cancer Center, Tathali, Nala Road, Bhaktapur, Province Bagmati, Nepal.

出版信息

J Racial Ethn Health Disparities. 2025 Apr 3. doi: 10.1007/s40615-025-02407-8.

Abstract

INTRODUCTION

Medication errors represent a significant source of healthcare-related harm, leading to mortality, morbidity, and substantial costs to health systems. Existing evidence highlights dissatisfaction and perceived discrimination experienced by patients from minority ethnic and disadvantaged backgrounds within healthcare settings.

OBJECTIVE

The study aimed to systematically review the literature on associations between patient race/ethnicity, socio-economic status, health literacy, and the incidence or patient experience of medication errors in healthcare and community (home) settings.

METHODS

A systematic review was conducted by searching an electronic database including EMBASE, MEDLINE, and PsycINFO. Studies published in English from January 2010 to October 2023, which explored the association between ethnicity, social disadvantage, and medication errors, were included.

RESULTS

Thirteen studies met the inclusion criteria from an initial identification of 2075 titles. Findings indicated that minority ethnic patients were more susceptible to prescription errors, undertreatment, administration errors, and suboptimal medication monitoring and follow-up by healthcare providers. Patients with low health literacy and limited English proficiency were also significantly likely to experience comprehension errors and medication discrepancies. Furthermore, ethnicity and social disadvantages were also associated with an increased risk of overdosing in pediatric medication administration, particularly among parents using dosing cups.

CONCLUSION

Minority ethnic background, low socio-economic status, and low health literacy can risk a higher likelihood of patients experiencing medication errors. Increasing awareness of these disparities among healthcare staff is essential for developing targeted interventions to mitigate inequalities in patient experiences and care outcomes in relation to medication use and safety. Future research should investigate the importance of intersectionality, such as multiple social disadvantages in this context.

摘要

引言

用药错误是医疗相关伤害的一个重要来源,会导致死亡、发病,并给卫生系统带来巨大成本。现有证据凸显了少数族裔和弱势背景患者在医疗环境中所经历的不满和感知到的歧视。

目的

本研究旨在系统回顾关于患者种族/族裔、社会经济地位、健康素养与医疗及社区(家庭)环境中用药错误发生率或患者用药错误经历之间关联的文献。

方法

通过检索包括EMBASE、MEDLINE和PsycINFO在内的电子数据库进行系统回顾。纳入2010年1月至2023年10月以英文发表的、探讨种族、社会劣势与用药错误之间关联的研究。

结果

从初步筛选出的2075篇文献标题中,有13项研究符合纳入标准。研究结果表明,少数族裔患者更容易出现处方错误、治疗不足、给药错误以及医疗服务提供者对用药监测和随访不佳的情况。健康素养低和英语水平有限的患者也显著更有可能出现理解错误和用药差异。此外,种族和社会劣势还与儿科用药过量风险增加有关,尤其是在使用量杯的家长中。

结论

少数族裔背景、社会经济地位低和健康素养低会使患者发生用药错误的可能性更高。提高医护人员对这些差异的认识对于制定针对性干预措施以减少患者在用药使用和安全方面的体验及护理结果不平等至关重要。未来研究应调查交叉性的重要性,比如在这种背景下的多种社会劣势。

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