Investigating Medication Errors in Daily Life: Discovering Person-specific and Situation-specific Risk Factors

项目摘要/摘要 为了在成年后期保持独立，一个人必须能够安全和可靠地参与 日常生活工具活动(IADL)，包括服用治疗慢性病的药物。 在不犯用药错误的情况下安全地进行这一操作的可能性取决于许多前提条件， 包括：服用不同药物的数量、认知状态(例如，痴呆症)、是否存在 照顾者或其他精神支架(例如，药物日记)和认知脆弱性(例如，易感性 分心)。用药差错不胜枚举--每年有100多万人受伤，98,000人死亡--而且还会发生 在医疗保健的各个领域(即护士、医生、药剂师、病人)，人们对此知之甚少 日常生活中的用药差错。对于此R03，我们特别感兴趣的是了解 在日常生活中犯下的用药错误，并发现特定于个人和特定情况的风险因素 家里的用药差错。对用药问题、用药方法的看法 复杂性，家庭用药错误的性质及其后果将在老年人中进行评估 爱因斯坦老龄化研究(EAS)目前招募的成年人，使用一种创新的三管齐下的药物 评估(例如，每日EMA用药问题、用药差错史访谈和研究 神经科医生，EHR的药物持有率)。利用现有的临床数据(即MCI评分)， 和认知表现数据(实验室内和动态评估)，我们将识别特定于个人的 各种类型用药差错的具体情况风险因素。这项工作的完成将突出 未来旨在减少用药差错的干预措施的可操作目标。

PROJECT SUMMARY/ABSTRACT In order to maintain independence into late adulthood, one must be able to safely and reliably participate in Instrumental Activities of Daily Living (IADLs), including taking medications for treatment of chronic conditions. The potential to do this safely without making a medication error depends on a multitude of pre-conditions, including: the number of distinct medications consumed, cognitive status (e.g., dementia), the presence of a caregiver or other mental scaffolds (i.e., medication diary), and cognitive vulnerability (e.g., susceptibility to distraction). Medication errors are numerous — over a million yearly injuries and 98,000 deaths — and occur across the spectrum of healthcare (i.e., nurses, physicians, pharmacists, patients), yet little is known about medication errors in daily life. For this R03, we are specifically interested in understanding the types of medication errors made in daily life, and discovering person-specific and situation-specific risk factors for medication errors in the home. Perceptions of medication administration problems, medication regimen complexity, and the nature of medication errors in the home and their consequences will be assessed in older adults currently recruited into the Einstein Aging Study (EAS), using an innovative three-pronged medication assessment (i.e., daily EMA of medication administration problems, medication error history interview with study neurologist, medication possession ratios from EHRs). Making use of existing clinical data (i.e., ratings of MCI), and cognitive performance data (both in-lab and ambulatory assessments) we will identify person-specific and situation-specific risk factors for various types of medication errors. Completion of this work will highlight actionable targets for future interventions targeting the reduction of medication errors.