Analysis on the pre-warnings of drug dosage errors in medical advices in elderly inpatients with renal insufficiency by the prescription review system
10.3760/cma.j.cn114015-20220124-00069
- VernacularTitle:审方系统对住院老年肾功能不全患者医嘱中药物剂量错误的预警情况分析
- Author:
Xiyue YUAN
1
;
Jihui CHEN
1
;
Jia ZHOU
1
Author Information
1. 上海交通大学医学院附属新华医院临床药学部，上海 200092
- Publication Type:Journal Article
- Keywords:
Renal insufficiency;
Prescription drug monitoring programs;
Medication errors;
Aged;
Pharmaceutical services
- From:
Adverse Drug Reactions Journal
2022;24(10):528-533
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To understand the pre-warnings of drug dosage errors in medical advices in elderly inpatients with renal insufficiency by the prescription review system.Methods:The pre-warnings of drug dosage errors in medical advices in ≥65 years old inpatients with renal insufficiency by the prescription review system in Xinhua Hospital Affiliated to Shanghai Jiao Tong University Medical College from January 1, 2021 to December 31, 2021 were reviewed, and the reasons for the wrong pre-warnings were analyzed. In the correct pre-warnings, the drugs involved in dosage errors related to kidney and the types of errors were evaluated, and the departments related to the occurrence of errors and the acceptance of physicians for pre-warnings were analyzed.Results:A total of 511 medical advices on pre-warnings related to drug dose in ≥65 years old patients with renal insufficiency were included in the analysis. One hundred and eighty-three medical advices (35.8%) were evaluated as wrong pre-warnings, and 328 (64.2%) were correct pre-warnings. The medical advices with correct pre-warnings involved 25 kinds of drugs, of which the most involved drugs was antibacterial drugs [57.62%(189/328)]; the second was cardiovascular system drugs [24.70% (81/328)], among which trimetazidine tablets was the most common. Among the correct pre-warnings, 315 (96.04%) were excessive dose, and 13 (3.96%) were insufficient dose. The most common error content of excessive dose was "excessive single dose and excessive daily dose" (53.33%, 168/315), followed by "high frequency, excessive daily dose" (41.59%, 131/315); the most common errors of insufficient dose was "low frequency, insufficient daily dose" (9/13). A total of 186 (56.7%) medical advices were corrected by physicians after accepting the pre-warnings, and 142 (43.3%) were not. The acceptance rate of surgeons for pre-warning of wrong orders was higher than that of physicians, with a statistically significant difference [73.3%(96/131) vs. 45.7%(90/197), P<0.001]. Conclusions:The effect of pre-warnings from the prescription review system on dosage errors related to kidney is positive. It is necessary to further improve the accuracy of the prescription review system for the dosage errors related to kidney, improve the acceptance of clinicians, and ensure the safety of patients.
