Tools for Optimizing Medication Safety (TOP-MEDS)

描述(由申请人提供)：我们提出了一个以优化药物安全工具(TOPMEDS)为主题的患者安全CERT。长期目标是通过开发和改进更安全的用药工具来提高患者的安全性。短期目标是在四个关键领域开发、测试、部署和传播工具和培训材料：大规模药物安全性和有效性比较研究的统计方法，急性疼痛的阿片类药物处方和剂量，防止和检测药品名称混淆错误的方法，以及以患者为中心、语言一致的药物信息。我们将开展以下具体目标的研究：1.开发和应用多变量、人时物流 大规模药物不良事件筛查的回归模型。2.通过开发和验证一种新型的基于网络的模拟器来培训处方医生正确选择和剂量阿片类药物，从而提高住院患者急性疼痛护理的安全性和有效性。3.完善药品名称上市前安全筛查的标准测试体系，制定和测试使用电子病历预防和检测药品名称混淆错误的方法。4.严格评估低识字率战略，以促进在城市初级保健环境中讲英语和西班牙语的患者安全有效地使用处方药。这些项目共同涉及所有五个方案利益领域：比较有效性、患者安全、工具开发、卫生保健系统干预以及将其转化为政策或实践。UIC将与拉什大学医学中心、西北大学、芝加哥大学、布里格姆妇女医院、识别系统公司、安全用药实践研究所和国家患者安全基金会的合作者共同主办该中心。我们的研究人员是统计学(Robert Gibbons)、健康素养(Michael Wolf)、药品名称混淆(Bruce Lambert)、医疗信息技术(Gordon Schiff、Bill Galanter)、疼痛护理(Robert McNutt和Diana Wilkie)、用药差错预防(Michael Cohen)和患者安全(Tim McDonald、Diane Pinakiewicz)等领域的国内和国际领导者。 公共卫生相关性：患者并不像他们应该的那样安全。卫生专业人员和患者的用药错误和不适当的用药会造成极大的危害。这项拟议的研究将通过开发和共享更安全用药的工具，包括检测药物风险、培训年轻医生、预防用药错误和使药物信息更容易理解的工具，使患者更安全。

DESCRIPTION (provided by applicant): We propose a patient safety CERT focused on the theme of Tools for Optimizing Medication Safety (TOPMEDS). The long term goal is to improve patient safety by developing and refining tools for safer medication use. The short term objective is to develop, test, deploy and disseminate tools and training materials in four key areas: statistical methods for large-scale studies of comparative drug safety and effectiveness, opioid prescribing and dosing for acute pain, methods for preventing and detecting drug name confusion errors, and patient-centered, language concordant drug information. We will carry out studies with the following specific aims: 1. Develop and apply a multivariate, person-time logistic regression model for large-scale adverse drug event screening. 2. Improve the safety and effectiveness of inpatient acute pain care by developing and validating a novel, web-based simulator to train prescribers in the proper selection and dosing of opioids. 3. Refine a standard battery of tests for pre-market safety screening of drug names, and develop and test methods for preventing and detecting drug name confusion errors using electronic medical records. 4. Rigorously evaluate a low literacy strategy for promoting safe and effective prescription medication use among English and Spanish-speaking patients in an urban primary care setting. Together the projects address all five of the programmatic interest areas: comparative effectiveness, patient safety, development of tools, health care system interventions, and translation into policy or practice. UIC will host the center, with collaborators at Rush Universit Medical Center, Northwestern University, University of Chicago, the Brigham and Women's Hospital, Discerning Systems, Inc., the Institute for Safe Medication Practices, and the National Patient Safety Foundation. Our investigators are national and international leaders in statistics (Robert Gibbons), health literacy (Michael Wolf), drug name confusion (Bruce Lambert), health information technology (Gordon Schiff, Bill Galanter), pain care (Robert McNutt and Diana Wilkie) medication error prevention (Michael Cohen) and patient safety (Tim McDonald, Diane Pinakiewicz). PUBLIC HEALTH RELEVANCE: Patients are not as safe as they should be. Medication errors and inappropriate use of medicines, by health professionals and patients, cause a great deal of harm. The proposed research will make patients safer by developing and sharing tools for safer medication use, including tools for detecting drug risks, for training young doctors, for preventin medication errors and for making drug information easier to understand.