Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Msrc types research (1)

204 views

Published on

Msrc types research

Published in: Science
  • Be the first to comment

  • Be the first to like this

Msrc types research (1)

  1. 1. Medication Safety Research: Types and Opportunities Monira Alwhaibi, Assistant Professor Clinical Pharmacy Department, College of Pharmacy Medication Safety Research Chair, King Saud University, Riyadh, Saudi Arabia 1
  2. 2. Medication Errors  Any preventable event that may cause or lead to inappropriate medication use or patient harm  These errors may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labelling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use 2 The National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP)
  3. 3. – an adverse event if a patient is harmed – a near miss if a patient is nearly harmed or – neither harm nor potential for harm A medication error may result in (Patient Outcome Categories)–… Medication errors are preventable 3
  4. 4. Why do we need Research on Medication Safety • Understand the factors that cause Medication Errors • A step to reduce Medication Errors • It is difficult to reduce or eliminate medication errors when information on their prevalence is absent, inaccurate, or contradictory • One of the Institute of Medicine (IOM) priority area for transforming health care 4 Raebel, M. A., Chester, E. A., Brand, D. W., & Magid, D. J. (2008). Imbedding Research in Practice to Improve Medication Safety.
  5. 5. Conducting Research on Medication Safety Outcome Target Population Research Area Causative factors OR Intervention 5
  6. 6. Epidemiological Formula-- Mathematical Consideration Y = α + βX1 + βX2 + βX3 + βX4+…..+ε 6 Causative factors/Intervention Outcome
  7. 7. Conducting Research on Medication Safety Outcome • Preventable adverse drug events (pADEs) • Hospital Admission due to Medication Errors • Emergency Department Visit • Death • Prescribing pattern  Codispensing of interacting drugs  Dispensing of contraindicated drugs (Pregnancy)  Prescribing of drugs to be avoided (elderly)  Dosage adjustment (Kidney disease) • INR monitoring (warfarin) • laboratory monitoring for High-Risk Drug Outcome Outcome Target Population Research Area Causative factors Raebel, M. A., Chester, E. A., Brand, D. W., & Magid, D. J. (2008). Imbedding Research in Practice to Improve Medication Safety. 7
  8. 8. Conducting Research on Medication Safety Research Area Three drug categories were responsible for 86.5% of pADEs: • cardiovascular drugs, • analgesics, and • hypoglycaemic agents. Research Area Outcome Study Population Research Area Causative factors Thomsen, L. A., Winterstein, A. G., S ndergaard, B., Haugb lle, L. S., & Melander, A. (2007). Systematic review of the incidence and characteristics of preventable adverse drug events in ambulatory care. Annals of Pharmacotherapy, 41(9), 1411-1426. 8
  9. 9. Conducting Research on Medication Safety Research Area • Cardiovascular • Genetic • Infectious • Oncology • Psychiatric Research Area Outcome Study Population Research Area Causative factors Thomsen, L. A., Winterstein, A. G., S ndergaard, B., Haugb lle, L. S., & Melander, A. (2007). Systematic review of the incidence and characteristics of preventable adverse drug events in ambulatory care. Annals of Pharmacotherapy, 41(9), 1411-1426. 9
  10. 10. Conducting Research on Medication Safety Study population • Patients • Healthcare providers (Physicians, Pharmacists, or Nurses) Target population Outcome Target Population Research Area Causative factors 10
  11. 11. Data indicated 5,366 medication error reports 68.2% resulted in serious patient outcomes 9.8% were fatal 48.6% occurred in patients over 60 years Improper dose (40.9%) Wrong drug (16%) Wrong route of administration (9.5%) 11 Phillips, J., Beam, S., Brinker, A., Holquist, C., Honig, P., Lee, L. Y., & Pamer, C. (2001). Retrospective analysis of mortalities associated with medication errors. American Journal of Health-System Pharmacy, 58(19), 1835-1841.
  12. 12. Factors related to safety Issues in Clinical Practice • Human Factors • Process Factors • System Factors The National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) , NCC MERP Taxonomy of Medication Errors Outcome Target Population Research Area Causative factors Causative Factors 12
  13. 13. Factors related to safety Issues in Clinical Practice • Individual characteristics • Skill/education/ experience • Knowledge of medications • Fatigue/Lack of Sleep • Miscalculation of Dosage or Infusion Rate • Inadequate screening for allergies, interactions, etc. Human Factors The National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) , NCC MERP Taxonomy of Medication Errors 13
  14. 14. Factors related to safety Issues in Clinical Practice • Documentation of medication • Supervision • Medication management and patient monitoring • Adhering to protocols for medication administration • Lack of double checking • Failure to follow policies and procedures • Unclear orders • Implementation of medication safety practices Process Factors The National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) , NCC MERP Taxonomy of Medication Errors 14
  15. 15. Factors related to safety Issues in Clinical Practice • Workload and staffing • Organizational climate (Lighting, Noise Level , etc.) • Length of work shift • Frequent Interruptions and distractions • Communication systems between health care practitioners • Patient counselling System Factors The National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) , NCC MERP Taxonomy of Medication Errors 15
  16. 16. Research Types to Assess Medication Safety? • Quantitative Research – Patient Reported Outcomes – Big Data Analysis – Meta-anlaysis, Systematic Review – Cost analysis • Qualitative Research Research Types 16
  17. 17. Quantitative Research -- Big Data Analysis  What Outcomes could be identified from EHR? • Prescribing pattern:  Codispensing of interacting drugs  Dispensing of contraindicated drugs (Pregnancy)  Prescribing of drugs to be avoided (elderly)  INR monitoring (warfarin)  Dosage adjustment (Kidney disease)  laboratory monitoring for High-Risk Drug  What Information could be identified from FDA reports?  Preventable adverse drug events (pADEs) -- (Harmful, Not harmful)  Population  Causes 17
  18. 18. Conclusions – Connect the dots 18 Outcome Target Population Research Area Causative factors Preventable Adverse Drug Events Elderly Patients with cardiovascular disease Cardiovascular • Pharmacist counseling • Age • Comorbid conditions • Prescriber • Encounter type • Polypharmacy Use
  19. 19. Conclusions – Connect the dots 19 Outcome Target Population Research Area Causative factors Dispensing of contraindicated drugs (Pregnancy) Pregnant Women Women Health • Age • Comorbid conditions • Prescriber
  20. 20. 20

×