The epidemiology of adverse drug events and medication errors among psychiatric inpatients in Japan: the JADE study.
The epidemiology of adverse drug events and medication errors among psychiatric inpatients in Japan: the JADE study.
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DOI：
10.1186/s12888-016-1009-0
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发表时间：
2016-08-30
期刊：
影响因子：
4.4
通讯作者：
Fukui K
中科院分区：
文献类型：
--
作者：
Ayani N;Sakuma M;Morimoto T;Kikuchi T;Watanabe K;Narumoto J;Fukui K
在西方国家以外，对精神科住院患者的不良药物事件(ADE)和用药差错的流行病学知识有限。ADE的性质和用药差错对于提高世界范围内的护理质量很重要；因此，我们在日本进行了日本不良药物事件研究，这是一系列在日本几个环境下进行的队列研究。这份报告包括448名住院患者，22,733个病人日，在精神病院和三级护理教学医院的精神病室超过1年。四名精神病学家和另外两名内科医生查阅了所有病历和相关文件，以确定可疑事件。医生后来将这些事件归类为ADE、潜在的ADE、用药差错或排除，并评估了如果这些事件是事件的严重性和可预防性。在研究期间，我们确定了955例不良反应和398例用药错误(发生率分别为每1000患者日42.0和17.5)。在ADE中，危及生命、严重和严重的分别为1.4%、28%和71%。抗精神病药物与一半的ADE有关。医疗护理病房的用药差错发生率高于急诊护理病房和护理护理病房(分别为每1000人日40.9、15.6和17.4)。监测和订购阶段是最常见的差错阶段(分别占全部用药差错的39%和34%)，76%的药品不良反应差错是在监测阶段发现的。与精神药物相比，非精神药物引起ADE错误的可能性是精神药物的三倍。精神科医生使用抗精神病药物、监测不足和治疗身体疾病可能是日本精神科住院患者用药差错和不良反应发生率高的原因之一。精神科医生在给精神病患者开抗精神病药物或陌生药物时应谨慎，并应在用药后对患者进行监测。
Knowledge of the epidemiology of adverse drug events (ADEs) and medication errors in psychiatric inpatients is limited outside Western countries. The nature of ADEs and medication errors are important for improving the quality of care worldwide; therefore, we conducted the Japan Adverse Drug Events Study, a series of cohort studies at several settings in Japan. This report included 448 inpatients with 22,733 patient-days in a psychiatric hospital and psychiatric units at a tertiary care teaching hospital over 1 year. Four psychiatrists and two other physicians reviewed all medical charts and related documents to identify suspected incidents. The physicians later classified those incidents into ADEs, potential ADEs, medication errors, or exclusions and evaluated the severity and preventability if the incidents were events. During the study period, we identified 955 ADEs and 398 medication errors (incidence: 42.0 and 17.5 per 1000 patient-days, respectively). Among ADEs, 1.4 %, 28 %, and 71 % were life-threatening, serious, and significant, respectively. Antipsychotics were associated with half of all ADEs. The incidence of medication errors was higher in medical care units than in acute and nursing care units (40.9, 15.6, and 17.4 per 1000 patient-days, respectively). The monitoring and ordering stages were the most common error stages (39 % and 34 % of all medication errors, respectively), and 76 % of medication errors with ADEs were found at the monitoring stage. Non-psychiatric drugs were three times as likely to cause ADEs with errors compared to psychiatric drugs. Antipsychotic use, inadequate monitoring, and treatment of physical ailments by psychiatrists may contribute to the high incidence of medication errors and ADEs among psychiatric inpatients in Japan. Psychiatrists should be cautious in prescribing antipsychotics or unfamiliar medications for physical problems in their psychiatric patients, and should monitor patients after medication administration.
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影响因子：
2.6
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