Medication errors in mental healthcare: a systematic review
Medication errors in mental healthcare: a systematic review
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DOI：
10.1136/qshc.2006.018267
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发表时间：
2006-12-01
影响因子：
--
通讯作者：
Paton, Carol
中科院分区：
文献类型：
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作者：
Maidment, Ian D.;Lelliott, Paul;Paton, Carol
背景：据估计，综合医院收治的患者中有 1-2% 因用药错误而受到伤害。以前没有对精神保健服务中用药错误的发生率、原因或类型进行过系统回顾。方法：对社区或医院精神保健服务中药物管理过程的一个或多个阶段中用药错误的发生率或原因进行了系统的文献检索。对研究设计和所使用的分母的结果进行了检查。结果：所有研究都检查了药物管理过程，而不是结果。在回顾性检查药物图表的研究中，报告的错误率最高，在依赖药剂师报告来识别错误的研究中，报告的错误率居中，在依赖组织事件报告系统的研究中，报告的错误率最低。研究发现的错误中只有少数造成了实际伤害，主要是因为在患者接受药物之前就发现了这些错误并采取了补救措施。研究的重点是住院患者和精神健康药剂师开出的处方。结论：关于精神保健中用药错误的研究是有限的。特别是，人们对非医院环境中错误的发生率或其造成的危害知之甚少。其他来源的证据表明，大量药物不良事件是由精神药物引起的。其中一些是可以预防的，因此可能是由于用药错误造成的。在此基础上，以及可能导致用药错误的精神卫生保健组织的特征，建议了未来研究的重点。
Background: It has been estimated that medication error harms 1-2% of patients admitted to general hospitals. There has been no previous systematic review of the incidence, cause or type of medication error in mental healthcare services.Methods: A systematic literature search for studies that examined the incidence or cause of medication error in one or more stage(s) of the medication-management process in the setting of a community or hospital-based mental healthcare service was undertaken. The results in the context of the design of the study and the denominator used were examined.Results: All studies examined medication management processes, as opposed to outcomes. The reported rate of error was highest in studies that retrospectively examined drug charts, intermediate in those that relied on reporting by pharmacists to identify error and lowest in those that relied on organisational incident reporting systems. Only a few of the errors identified by the studies caused actual harm, mostly because they were detected and remedial action was taken before the patient received the drug. The focus of the research was on inpatients and prescriptions dispensed by mental health pharmacists.Conclusion: Research about medication error in mental healthcare is limited. In particular, very little is known about the incidence of error in non-hospital settings or about the harm caused by it. Evidence is available from other sources that a substantial number of adverse drug events are caused by psychotropic drugs. Some of these are preventable and might probably, therefore, be due to medication error. On the basis of this and features of the organisation of mental healthcare that might predispose to medication error, priorities for future research are suggested.