Development of high-alert medication recommended list based on big data of medication error reports in China
10.3760/cma.j.cn114015-20241121-00160
- VernacularTitle:基于中国用药错误报告大数据的高警示药品推荐目录制定
- Author:
Siyan LI
1
;
Yuqin WANG
;
Suying YAN
;
Yujie QIU
;
Qiang ZHANG
;
Qingxia ZHANG
Author Information
1. 首都医科大学宣武医院药学部，国家老年疾病临床医学研究中心，北京 100053
- Publication Type:Journal Article
- Keywords:
Medication errors;
Big data;
High-alert medication;
Delphi technique;
Drug list
- From:
Adverse Drug Reactions Journal
2025;27(10):613-620
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To construct a recommended list of high-alert medication (HAM) based on big data from medication error (ME) reports in China, providing reference for preventing and reducing HAM-related risks.Methods:The drugs involved in the serious ME reports of the National Monitoring Network for Clinical Safe Medication (Monitoring Network) were collected (as of December 31, 2023), and the candidate drugs were preliminarily determined referring to the HAM list of China 2023 (Chinese list) and the latest three lists of American Institute for Safe Medication Practices (ISMP). Candidate drugs that were included in both the Chinese list and ISMP lists, as well as those existed in the Chinese list but had never been included in the ISMP lists were included in the current list, and their risk levels followed the original risks in the Chinese list. Candidate drugs that existed in the Chinese list but had been excluded from the ISMP lists, and those existed in the ISMP lists but had not been included in the Chinese list were listed as suspected drugs. For the other candidate drugs, those did not meet the definition of HAM were excluded firstly, and those related to ME that had caused serious harm were listed as suspected drugs, according to the judicial cases on ME of China Judgements Online and PKULAW database. Two methods, including Delphi expert consultation and questionnaire survey, were used to determine whether the above suspected drugs were included in the HAM list and their risk levels.Results:A total of 138 drugs were obtained through the initial screening, 106 of which were directly included in the current list, and 32 of which were listed as drugs requiring further assessment. After 2 rounds of Delphi expert consultation by 18 experts and surveys with 136 valid questionnaires, 32 suspected drugs did not meet the inclusion criteria. Finally, a total of 106 drugs were included in the current list, including 51 A-class drugs in 9 categories, 33 B-class drugs in 9 categories, and 22 C-class drugs in 5 categories.Conclusion:Based on the big data of the ME reports in China, a HAM list is constructed, which is accurate and concise and better fits the actual clinical drug risks in China, helping to improve the drug safety management.
