Analysis of variations in the display of drug names in computerized prescriber-order-entry systems
Analysis of variations in the display of drug names in computerized prescriber-order-entry systems
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DOI：
10.2146/ajhp151051
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发表时间：
2017-04-01
影响因子：
2.7
通讯作者：
Schiff, Gordon D.
中科院分区：
文献类型：
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作者：
Quist, Arbor J. L.;Hickman, Thu-Trang T.;Schiff, Gordon D.
目的。对计算机化处方者医嘱输入 (CPOE) 系统中药物名称显示方式的变化进行了分析，以确定它们对潜在用药错误的影响。方法。对 10 家住院和门诊 CPOE 系统供应商以及 6 家美国医疗机构自行开发的 CPOE 系统进行了评估。由药剂师、医生、患者安全专家和信息学专家组成的团队创建了 CPOE 评估工具，以标准化所研究系统中 CPOE 功能的评估。我们对测试患者进行了假设场景，以研究药物订购工作流程以及每个系统中药物的显示方式。在 1 个大型门诊系统中对品牌药名与非专利药名订购进行了研究，以了解处方者为何同时订购同一药物的品牌药和非专利药。结果。在 6 个研究中心和 10 个系统内部和之间观察到药物名称显示存在广泛差异，包括品牌名称和通用名称的显示不一致。即使在同一屏幕上，有些药物的显示也有所不同。组合产品的显示常常不一致，一些系统要求处方者知道组合中列出的第一种药物，以便在搜索中出现正确的产品。处方医生可能同时开出同一药物的品牌药和仿制药，从而可能出现药物重复错误。结论。对 10 个 CPOE 系统的审查显示，药物名称显示不一致，这可能会导致审查、选择和订购药物时出现混乱或错误。
Purpose. The variations in how drug names are displayed in computerized prescriber-order-entry (CPOE) systems were analyzed to determine their contribution to potential medication errors.Methods. A diverse set of 10 inpatient and outpatient CPOE system vendors and self-developed CPOE systems in 6 U.S. healthcare institutions was evaluated. A team of pharmacists, physicians, patient-safety experts, and informatics experts created a CPOE assessment tool to standardize the assessment of CPOE features across the systems studied. Hypothetical scenarios were conducted with test patients to study the medication ordering workflow and ways in which medications were displayed in each system. Brand versus generic drug name ordering was studied at 1 large outpatient system to understand why prescribers ordered both brand and generic forms of the same drug.Results. Widespread variations in the display of drug names were observed both within and across the 6 study sites and 10 systems, including the inconsistent display of brand and generic names. Some displayed drugs differently even on the same screen. Combination products were often displayed inconsistently, and some systems required prescribers to know the first drug listed in the combination in order for the correct product to appear in a search. It also appeared that prescribers may have prescribed both brand and generic forms of the same medication, creating the potential for drug duplication errors.Conclusion. A review of 10 CPOE systems revealed that medication names were displayed inconsistently, which can result in confusion or errors in reviewing, selecting, and ordering medications.