Objective To analyze the current status of knowledge,attitude,and behavior?(KAP)of doctors and pharmacists regarding iodine contrast agent allergic reactions in medical institutions in China and the influencing factors,to provide reference for the treatment of iodine contrast agent allergic patients.Methods A questionnaire survey on iodine contrast agent allergic reactions was conducted among doctors and pharmacists in China using a self-designed questionnaire.The questionnaire was distributed online via WeChat and the participants were anonymous and voluntary.The scores of knowledge,attitude,and behavior of medical staff of different genders,departments,and titles were statistically analyzed.Wilcoxon rank sum test and multiple linear regression analysis were used to analyze the influencing factors.Results A total of 105 doctors and pharmacists from 19 provinces,autonomous regions and municipalities participated in the survey,completing 105 valid questionnaires.The knowledge score(out of 4 points),attitude score(out of 3 points),and behavior score(out of 3 points)of doctors and pharmacists regarding contrast agent allergy reactions were 2(1,2)points,1(0,2)points,and 1(1,2)points,respectively.Multivariate linear regression analysis showed that job title is a factor affecting the knowledge score.Compared to those with primary and below titles,senior title doctors and pharmacists had higher knowledge scores(P=0.007).Educational level is a influence factor affecting the attitude score.Compared to those with undergraduate and below educational levels,doctors and pharmacists with doctoral degrees had more positive attitudes(P=0.011).Attitude score is a influence factor affecting the behavior score,the more positive the attitude,the more positive the behavior(P=0.015).Conclusion The knowledge,attitude,and practice(KAP)of doctors and pharmacists regarding contrast agent allergy reactions need to be strengthened.Training should be conducted for doctors and pharmacists,taking into account the KAP differences among individuals with different job titles and educational levels,to enhance knowledge levels and actively explore safe and effective desensitization treatment methods for patients with contrast agent allergies.The use of iodinated contrast agents should be rationalized while ensuring patient safety.

In 2024, a total of 27 309 cases of medication error (ME) from 484 hospitals in 27 provincial administrative regions were collected in the National Monitoring Network for Clinical Safe Medication. Among them, 279 (1.02%) were classified as grade A, 22 081 (80.86%) as grade B, 4 268 (15.63%) as grade C, 472 (1.73%) as grade D, 96 (0.35%) as grade E, 105 (0.38%) as grade F, 6 (0.02%) as grade H, and 2 (<0.01%) as grade I; no MEs of grade G occurred. Among the 27 030 patients involved in MEs of grade B to I, 15 124 (55.95%) were male and 11 906 (44.05%) were female; their ages were from 1 day to 104 years; 3 369 (12.46%) were children (<18 years old), 12 113 (44.81%) were young and middle-aged adults (≥18 to <60 years old), and 11 548 (42.72%) were elderly (≥60 years old). The top 3 contents of ME were wrong drug class (5 347 cases, 19.13%), wrong dosage (4 913 cases, 17.58%), and wrong administration frequency (3 429 cases, 12.27%). Among the 27 030 grade B-I MEs, the main person who triggered the event were physicians (18 703 cases, 69.19%) and pharmacists (6 343 cases, 23.47%). These MEs mainly occurred in clinics (11 009 cases, 40.73%), in hospital wards (7 393 cases, 27.35%), and in pharmacies (6 219 cases, 23.27%). The main persons who discovered the MEs were pharmacists (21 021 cases, 74.14%). The top 3 factors causing ME were lack of related pharmacologic knowledge (8 716 cases, 26.49%), tiredness (5 755 cases, 17.49%), and inexperienced skills (4 505 cases, 13.69%). A total of 209 patients were involved in severe MEs (grade E-I), including 133 (63.64%) males and 76 (36.36%) females, aged from 21 months to 94 years, of which 42 (20.10%) were children, 75 (35.88%) were young and middle-aged adults, and 92 (44.02%) were elderly. The top 3 diseases diagnosed in severe MEs were drug poisoning (41 cases, 19.62%), diabetes (34 cases, 16.27%), and hypertension (14 cases, 6.70%); the main person who triggered the MEs were patients and their families (135 cases, 64.59%); the MEs occurred mainly in patients′ houses (116 cases, 55.50%). Drug poisoning was mainly related to accidental ingestion by children, and MEs in patients with diabetes and hypertension were often related to issues on patient compliance. Based on the data of MEs in 2024, it was proposed to establish a better medication safety culture and improve the ME reporting situation in China, pay attention to the risks of misusing external drugs for internal use, children′s accidental ingestion and insulin-related MEs, strengthen the prevention of MEs related to look-alike sound-alike drugs, pay attention to the post administration management and the compliance education of home care for patients with chronic diseases, so as to improve the medication safety of patients in China.

Objective To analyze the current status of knowledge,attitude,and behavior?(KAP)of doctors and pharmacists regarding iodine contrast agent allergic reactions in medical institutions in China and the influencing factors,to provide reference for the treatment of iodine contrast agent allergic patients.Methods A questionnaire survey on iodine contrast agent allergic reactions was conducted among doctors and pharmacists in China using a self-designed questionnaire.The questionnaire was distributed online via WeChat and the participants were anonymous and voluntary.The scores of knowledge,attitude,and behavior of medical staff of different genders,departments,and titles were statistically analyzed.Wilcoxon rank sum test and multiple linear regression analysis were used to analyze the influencing factors.Results A total of 105 doctors and pharmacists from 19 provinces,autonomous regions and municipalities participated in the survey,completing 105 valid questionnaires.The knowledge score(out of 4 points),attitude score(out of 3 points),and behavior score(out of 3 points)of doctors and pharmacists regarding contrast agent allergy reactions were 2(1,2)points,1(0,2)points,and 1(1,2)points,respectively.Multivariate linear regression analysis showed that job title is a factor affecting the knowledge score.Compared to those with primary and below titles,senior title doctors and pharmacists had higher knowledge scores(P=0.007).Educational level is a influence factor affecting the attitude score.Compared to those with undergraduate and below educational levels,doctors and pharmacists with doctoral degrees had more positive attitudes(P=0.011).Attitude score is a influence factor affecting the behavior score,the more positive the attitude,the more positive the behavior(P=0.015).Conclusion The knowledge,attitude,and practice(KAP)of doctors and pharmacists regarding contrast agent allergy reactions need to be strengthened.Training should be conducted for doctors and pharmacists,taking into account the KAP differences among individuals with different job titles and educational levels,to enhance knowledge levels and actively explore safe and effective desensitization treatment methods for patients with contrast agent allergies.The use of iodinated contrast agents should be rationalized while ensuring patient safety.

In 2024, a total of 27 309 cases of medication error (ME) from 484 hospitals in 27 provincial administrative regions were collected in the National Monitoring Network for Clinical Safe Medication. Among them, 279 (1.02%) were classified as grade A, 22 081 (80.86%) as grade B, 4 268 (15.63%) as grade C, 472 (1.73%) as grade D, 96 (0.35%) as grade E, 105 (0.38%) as grade F, 6 (0.02%) as grade H, and 2 (<0.01%) as grade I; no MEs of grade G occurred. Among the 27 030 patients involved in MEs of grade B to I, 15 124 (55.95%) were male and 11 906 (44.05%) were female; their ages were from 1 day to 104 years; 3 369 (12.46%) were children (<18 years old), 12 113 (44.81%) were young and middle-aged adults (≥18 to <60 years old), and 11 548 (42.72%) were elderly (≥60 years old). The top 3 contents of ME were wrong drug class (5 347 cases, 19.13%), wrong dosage (4 913 cases, 17.58%), and wrong administration frequency (3 429 cases, 12.27%). Among the 27 030 grade B-I MEs, the main person who triggered the event were physicians (18 703 cases, 69.19%) and pharmacists (6 343 cases, 23.47%). These MEs mainly occurred in clinics (11 009 cases, 40.73%), in hospital wards (7 393 cases, 27.35%), and in pharmacies (6 219 cases, 23.27%). The main persons who discovered the MEs were pharmacists (21 021 cases, 74.14%). The top 3 factors causing ME were lack of related pharmacologic knowledge (8 716 cases, 26.49%), tiredness (5 755 cases, 17.49%), and inexperienced skills (4 505 cases, 13.69%). A total of 209 patients were involved in severe MEs (grade E-I), including 133 (63.64%) males and 76 (36.36%) females, aged from 21 months to 94 years, of which 42 (20.10%) were children, 75 (35.88%) were young and middle-aged adults, and 92 (44.02%) were elderly. The top 3 diseases diagnosed in severe MEs were drug poisoning (41 cases, 19.62%), diabetes (34 cases, 16.27%), and hypertension (14 cases, 6.70%); the main person who triggered the MEs were patients and their families (135 cases, 64.59%); the MEs occurred mainly in patients′ houses (116 cases, 55.50%). Drug poisoning was mainly related to accidental ingestion by children, and MEs in patients with diabetes and hypertension were often related to issues on patient compliance. Based on the data of MEs in 2024, it was proposed to establish a better medication safety culture and improve the ME reporting situation in China, pay attention to the risks of misusing external drugs for internal use, children′s accidental ingestion and insulin-related MEs, strengthen the prevention of MEs related to look-alike sound-alike drugs, pay attention to the post administration management and the compliance education of home care for patients with chronic diseases, so as to improve the medication safety of patients in China.

OBJECTIVE To compare the general status of training programs for geriatric clinical pharmacists in China and the United States， and provide a reference for further optimizing training programs of geriatric clinical pharmacists in China. METHODS Retrieved from the American Society of Health-System Pharmacists （ASHP） website and the Chinese Hospital Association website， the detailed information and data on training outline， institution type/scale， enrollment number， training contents， project application conditions and graduation assessments for clinical pharmacists in geriatric field were collected and statistical analysis was performed using Excel software. RESULTS & CONCLUSIONS As of January 12， 2024， ASHP provided 24 geriatric clinical pharmacist training programs and 25 positions available for application in the postgraduate year two training， which provided compensation. The training base involved hospitals and pharmaceutical colleges， with varying scales. Applicants needed to obtain a doctor of pharmacy and complete postgraduate year one training. ASHP had designed detailed training objectives for the four essential skills of basic patient care， advanced patient care， leadership and management skills， and knowledge education and teaching dissemination. Each training base could appropriately add optional skills such as academic skills， long-term care skills and other skills according to its characteristics， developed a student rotation plan， and conducted assessments and evaluations at multiple time points during the training process. There were 5 training programs for geriatric clinical pharmacists in China， with 15 positions， which didn’t provide compensation； training bases were all third-grade class A hospitals with relatively large scale. The applicant needed to obtain a bachelor’s degree or above， and different years of work were required based on their major and degree level. The Pharmaceutical Specialized Committee of the China Hospital Association had established a detailed training outline， proposing specific training objectives on theoretical knowledge， practical skills， scientific research thinking， etc. The training base organized assessments and evaluations at the time of enrollment， completion of specified content training， and graduation. According to the experience of the US， it is recommended to provide differentiated knowledge and skills training for students at different levels， flexibly arrange rotating departments， require students to work independently and deeply participate in clinical teaching and research work， conduct multiple and various forms of assessments， and adjust learning plans in a 13264273306@126.com timely manner to comprehensively enhance their abilities.

In 2023, a total of 27 742 cases of medication error (ME) from 439 hospitals in 27 provincial administrative regions were collected in the National Monitoring Network for Clinical Safe Medication. Among them, 282 (1.02%) were classified as grade A, 22 452 (80.93%) as grade B, 4 239 (15.28%) as grade C, 499 (1.80%) as grade D, 141 (0.51%) as grade E, 127 (0.46%) as grade F, 1 (<0.01%) as grade G, and 1 (<0.01%) as grade I; no MEs of grade H occurred. Among the 27 460 patients involved in MEs of grade B to I, 15 131 (55.10%) were male and 12 329 (44.23%) were female; their ages were from 1 day to 103 years; 3 198 (11.65%) were children (<18 years old), 12 576 (45.80%) were young and middle-aged adults (≥18 to <60 years old), and 11 686 (42.56%) were elderly (≥60 years old). The top 3 contents of ME were wrong drug class (5 880 cases, 20.97%), wrong dosage (4 668 cases, 16.65%), and wrong administration frequency (3 184 cases, 11.35%). A total of 270 patients were involved in severe MEs (grade E-I), including 140 (51.85%) males and 130 (48.15%) females, aged from 52 days to 94 years, of which 31 (11.48%) were children, 91 (33.70%) were young and middle-aged adults, and 148 (54.82%) were elderly. The top 3 drugs involved were cefoperazone sodium and sulbactam sodium, metformin, and estazolam. One fatal ME was caused by mistakenly orally taking Fufang Jingjie for fumigation and washing. Among the 27 460 grade B-I MEs, 19 655 (71.58%) were triggered by physicians, 5 688 (20.71%) by pharmacists, and few by nurses, patients and their family members, etc. These MEs mainly occurred in clinics (10 537 cases, 38.37%), in hospital wards (8 187 cases, 29.81%), and in pharmacies (6 470 cases, 23.56%). But among the 270 severe MEs, 121 (44.81%) occurred in the patient′s home. The top 3 persons who discovered the ME were pharmacists (20 693 cases, 74.46%), patients and their family members (3 240 cases, 11.66%), and physicians (2 214 cases, 7.97%). The top 3 factors causing ME were lack of related pharmacologic knowledge (9 382 cases, 28.3%), tiredness (5 974 cases, 18.05%), and insufficient training of medical workers (3 831 cases, 11.58%). In view of MEs with high incidence or more severe in 2023, relevant risks should be paid attention to, including misusing external drugs for internal use, ingestion of drug packaging by mistake, wrong dose conversion in children, ME in special dosing frequency, too fast infusion speed of enteral nutrition preparations and irritant intravenous preparations, interaction between montmorillonite powder and other drugs, hypernatremia caused by fosfomycin sodium, etc. In addition, strengthening the management of drug varieties with frequent severe MEs and fatal MEs, as well as the popular science and safe drug use education for patients, can help ensure the medication safety of patients.

Objective:To explore the application value of semantic information retrieval (semantic retrieval) based on case reports dataset of Adverse Drug Reactions Journal. Methods:The dataset used in this study consists of 2 597 PDF files of case reports published on Adverse Drug Reactions Journal from 1999 to 2022. The semantic retrieval system is built by Baidu PaddlePaddle′s deep learning framework, the code was written in Python, and the text encoding model was Baidu RocketQA model. The precision at position k (P@k), recall at position k (R@k), mean reciprocal rank (MRR), mean average precision (MAP) and precision-recall (P-R) curve were used to evaluate the performance of semantic retrieval. The performance of semantic retrieval and keyword matching retrieval were compared by calculating the recall. Results:The set of preprocessed theme fields as items to be retrieved contained 2 597 documents, the set of search terms (queries) after removing deplicates and reorganizing included 1 388 drug name queries and 1 118 adverse reactions/events queries. The precision of drug name queries and adverse reactions/events queries by semantic retrieval were 0.667-1 and 0.566-1, and their recall were 0.667-0.871 and 0.566-0.863, respectively. The P-R curves of the top 1, 3, 5 and 10 documents in the semantic retrieval results using drug names queries and adverse reactions/events search terms showed that the precision decreased slowly in top 1 and 3 documents but significantly in top 5 and 10 documents with the increase of recall. The MRR of the 2 types of search terms were 0.854 and 0.871, and the MAP were 0.778 and 0.773, respectively. Using adverse reactions/events as search terms, semantic retrieval has a higher recall rate than keyword matching retrieval; using drug names as search terms, the recall rate of keyword matching retrieval is generally higher than that of semantic retrieval.Conclusions:The semantic retrieval system based on Baidu PaddlePaddle deep learning framework has good retrieval performance on the case reports dataset of Adverse Drug Reactions Journal. The semantic retrieval performs better with adverse reactions/events queries, while the keyword matching retrieval performs better with drug name queries.

Polymyxin B is a cyclopeptide antibiotic drug with a narrow therapeutic window and critical nephrotoxicity. However, with the emergence of carbapenem-resistant organisms and the increase of multidrug resistant and polydrug resistant, the clinical value of polymyxin B was emphasized. It has become the last defense against polydrug resistant Gram-negative bacterial infections. The pharmacokinetic process of polymyxin B is affected by physiological and pathological changes in critically ill patients. At present, guidelines and consensus do not recommend dose adjustment based on the severity of renal injury, there is a lack of basis for dosage selection in patients receiving continuous renal replacement therapy, and different views exist in some pharmacokinetic studies and clinical studies. However, it is helpful to improve disease prognosis and reduce the risk of nephrotoxicity to carry out therapeutic drug monitoring of polymyxin B in patients with renal insufficiency, to adjust the dose according to the monitoring results, and to realize precision medication.

In 2023, a total of 27 742 cases of medication error (ME) from 439 hospitals in 27 provincial administrative regions were collected in the National Monitoring Network for Clinical Safe Medication. Among them, 282 (1.02%) were classified as grade A, 22 452 (80.93%) as grade B, 4 239 (15.28%) as grade C, 499 (1.80%) as grade D, 141 (0.51%) as grade E, 127 (0.46%) as grade F, 1 (<0.01%) as grade G, and 1 (<0.01%) as grade I; no MEs of grade H occurred. Among the 27 460 patients involved in MEs of grade B to I, 15 131 (55.10%) were male and 12 329 (44.23%) were female; their ages were from 1 day to 103 years; 3 198 (11.65%) were children (<18 years old), 12 576 (45.80%) were young and middle-aged adults (≥18 to <60 years old), and 11 686 (42.56%) were elderly (≥60 years old). The top 3 contents of ME were wrong drug class (5 880 cases, 20.97%), wrong dosage (4 668 cases, 16.65%), and wrong administration frequency (3 184 cases, 11.35%). A total of 270 patients were involved in severe MEs (grade E-I), including 140 (51.85%) males and 130 (48.15%) females, aged from 52 days to 94 years, of which 31 (11.48%) were children, 91 (33.70%) were young and middle-aged adults, and 148 (54.82%) were elderly. The top 3 drugs involved were cefoperazone sodium and sulbactam sodium, metformin, and estazolam. One fatal ME was caused by mistakenly orally taking Fufang Jingjie for fumigation and washing. Among the 27 460 grade B-I MEs, 19 655 (71.58%) were triggered by physicians, 5 688 (20.71%) by pharmacists, and few by nurses, patients and their family members, etc. These MEs mainly occurred in clinics (10 537 cases, 38.37%), in hospital wards (8 187 cases, 29.81%), and in pharmacies (6 470 cases, 23.56%). But among the 270 severe MEs, 121 (44.81%) occurred in the patient′s home. The top 3 persons who discovered the ME were pharmacists (20 693 cases, 74.46%), patients and their family members (3 240 cases, 11.66%), and physicians (2 214 cases, 7.97%). The top 3 factors causing ME were lack of related pharmacologic knowledge (9 382 cases, 28.3%), tiredness (5 974 cases, 18.05%), and insufficient training of medical workers (3 831 cases, 11.58%). In view of MEs with high incidence or more severe in 2023, relevant risks should be paid attention to, including misusing external drugs for internal use, ingestion of drug packaging by mistake, wrong dose conversion in children, ME in special dosing frequency, too fast infusion speed of enteral nutrition preparations and irritant intravenous preparations, interaction between montmorillonite powder and other drugs, hypernatremia caused by fosfomycin sodium, etc. In addition, strengthening the management of drug varieties with frequent severe MEs and fatal MEs, as well as the popular science and safe drug use education for patients, can help ensure the medication safety of patients.

Objective:To explore the application value of semantic information retrieval (semantic retrieval) based on case reports dataset of Adverse Drug Reactions Journal. Methods:The dataset used in this study consists of 2 597 PDF files of case reports published on Adverse Drug Reactions Journal from 1999 to 2022. The semantic retrieval system is built by Baidu PaddlePaddle′s deep learning framework, the code was written in Python, and the text encoding model was Baidu RocketQA model. The precision at position k (P@k), recall at position k (R@k), mean reciprocal rank (MRR), mean average precision (MAP) and precision-recall (P-R) curve were used to evaluate the performance of semantic retrieval. The performance of semantic retrieval and keyword matching retrieval were compared by calculating the recall. Results:The set of preprocessed theme fields as items to be retrieved contained 2 597 documents, the set of search terms (queries) after removing deplicates and reorganizing included 1 388 drug name queries and 1 118 adverse reactions/events queries. The precision of drug name queries and adverse reactions/events queries by semantic retrieval were 0.667-1 and 0.566-1, and their recall were 0.667-0.871 and 0.566-0.863, respectively. The P-R curves of the top 1, 3, 5 and 10 documents in the semantic retrieval results using drug names queries and adverse reactions/events search terms showed that the precision decreased slowly in top 1 and 3 documents but significantly in top 5 and 10 documents with the increase of recall. The MRR of the 2 types of search terms were 0.854 and 0.871, and the MAP were 0.778 and 0.773, respectively. Using adverse reactions/events as search terms, semantic retrieval has a higher recall rate than keyword matching retrieval; using drug names as search terms, the recall rate of keyword matching retrieval is generally higher than that of semantic retrieval.Conclusions:The semantic retrieval system based on Baidu PaddlePaddle deep learning framework has good retrieval performance on the case reports dataset of Adverse Drug Reactions Journal. The semantic retrieval performs better with adverse reactions/events queries, while the keyword matching retrieval performs better with drug name queries.