Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.
Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.
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DOI：
10.1136/bmjqs-2015-005099
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发表时间：
2017-05
影响因子：
5.4
通讯作者：
Lambert BL
中科院分区：
文献类型：
--
作者：
Schroeder SR;Salomon MM;Galanter WL;Schiff GD;Vaida AJ;Gaunt MJ;Bryson ML;Rash C;Falck S;Lambert BL
药品名称混淆是一种常见的用药错误，对患者安全构成持续威胁。在美国，大约每一千张处方中就有一张会导致错误的药物被填写，其中大多数错误都涉及药物名称的外观或声音相似。在批准之前，药物名称要经过各种测试，以评估其易混淆性的可能性，但这些批准前的测试都没有显示出预测真实世界的错误率。我们进行了一项研究，以评估基于实验室的药物名称记忆和感知测试的错误率与现实世界药物名称混淆错误率之间的关联。80名参与者，包括医生，护士，药剂师，技术人员和外行人，完成了一系列实验室测试，评估视觉感知，听觉感知和短期记忆的外观相似和声音相似的药物名称对（如，羟嗪/肼屈嗪）。实验室测试错误率（和其他指标）显著预测了从大型门诊药房连锁店获得的真实世界错误率，最佳拟合模型占真实世界错误率方差的37%。交叉验证分析证实了这些结果，表明实验室测试也预测了第二家连锁药店的错误，其中45%的方差由实验室测试数据解释。在两个不同的连锁药店中，在真实的世界中观察到的药品名称混淆错误率与在基于实验室的记忆和感知测试中观察到的错误率之间存在强烈而显著的关联。监管机构和制药公司寻求一种有效的预先批准方法来识别混淆的药物名称，应该考虑使用这些简单的测试。通过使用标准的记忆和感知测试，应该可以减少进入市场的令人困惑的看起来相似和听起来相似的药物名称对的数量，这将有助于保护患者免受潜在有害的用药错误的影响。
Drug name confusion is a common type of medication error and a persistent threat to patient safety. In the USA, roughly one per thousand prescriptions results in the wrong drug being filled, and most of these errors involve drug names that look or sound alike. Prior to approval, drug names undergo a variety of tests to assess their potential for confusability, but none of these preapproval tests has been shown to predict real-world error rates. We conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. Eighty participants, comprising doctors, nurses, pharmacists, technicians and lay people, completed a battery of laboratory tests assessing visual perception, auditory perception and short-term memory of look-alike and sound-alike drug name pairs (eg, hydroxyzine/hydralazine). Laboratory test error rates (and other metrics) significantly predicted real-world error rates obtained from a large, outpatient pharmacy chain, with the best-fitting model accounting for 37% of the variance in real-world error rates. Cross-validation analyses confirmed these results, showing that the laboratory tests also predicted errors from a second pharmacy chain, with 45% of the variance being explained by the laboratory test data. Across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception. Regulators and drug companies seeking a validated preapproval method for identifying confusing drug names ought to consider using these simple tests. By using a standard battery of memory and perception tests, it should be possible to reduce the number of confusing look-alike and sound-alike drug name pairs that reach the market, which will help protect patients from potentially harmful medication errors.
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影响因子：
5.4
作者：
Lambert, BL;Chang, KY;Lin, SJ
通讯作者：
Lin, SJ
DOI：
10.1136/amiajnl-2012-001555
发表时间：
2013-05-01
影响因子：
6.4
作者：
Galanter, William;Falck, Suzanne;Lambert, Bruce L.
通讯作者：
Lambert, Bruce L.
辛普森的悖论，勋爵的悖论和抑制作用是相同的现象 - 逆转悖论。
影响因子：
2.3
作者：
Tu, Yu-Kang;Gunnell, David;Gilthorpe, Mark S
通讯作者：
Gilthorpe, Mark S
影响因子：
3
作者：
Lambert, BL;Lin, SJ;Gandhi, SK
通讯作者：
Gandhi, SK
影响因子：
5.4
作者：
Lambert, BL;Chang, KY;Gupta, P
通讯作者：
Gupta, P