Prescription errors in a primary care university unit: urgency of pharmaceutical care in Mexico

Miriam Zavaleta-Bustos, Lucila I. Castro-Pastrana, Ivette Reyes-Hernández, M. López-Luna, Isis-Beatriz Bermúdez-Camps
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引用次数: 33

Abstract

The purpose of this study was to assess prescription rationality and most common prescription errors at the primary care clinic of a Mexican university.A retrospective drug utilization review of indication-prescription type was carried out. A random sample of 370 medical records of patients assisted over a year period, were reviewed. Prescription appropriateness was evaluated according to the variables: indication, dosage regimen, administration route, contraindications, interactions, medication duplicity, unnecessary or missing medications. Prescriptions were rated as appropriate (no prescription errors found) or inappropriate (at least one prescription error found). The benefit-risk ratio was calculated for each prescription. This study revealed a 58% of inappropriate prescriptions in the Mexican primary care university clinic, mostly due to errors on dosage regimen and innapropiate drug selection. As a result of c2 analysis, it was found that the pharmacotherapeutic variables chosen for the prescription assessment in this study, were determinant in prescription appropriateness rating. Nimesulide, ciprofloxacin, ranitidine, ketorolac and paracetamol were the most prescribed drugs as well as the most common cause of errors found. The prescription error rate revealed by this study addresses the need for strategies to improve prescription's quality. Introducing pharmacists as a key part of health care team is a mean proposed to prevent medication errors and to solve the urgency of pharmaceutical care implementation in all primary care facilities in Mexico.
处方错误在初级保健大学单位:在墨西哥药物护理的紧迫性
本研究的目的是评估处方合理性和最常见的处方错误在墨西哥大学的初级保健诊所。回顾性分析了适应证处方类型的用药情况。在一年的时间里,对370个病人的医疗记录随机抽样进行了审查。根据适应症、给药方案、给药途径、禁忌症、相互作用、药物重复、不必要或遗漏药物等变量评估处方的适宜性。处方被评为适当(未发现处方错误)或不适当(至少发现一个处方错误)。计算每个处方的收益风险比。这项研究揭示了58%的不适当处方在墨西哥初级保健大学诊所,主要是由于错误的剂量方案和内丙酸药物选择。通过c2分析发现,本研究中用于处方评估的药物治疗变量是处方适宜性评级的决定因素。尼美舒利、环丙沙星、雷尼替丁、酮酸和扑热息痛是处方最多的药物,也是最常见的错误原因。本研究揭示的处方错误率表明需要制定提高处方质量的策略。引入药剂师作为卫生保健团队的关键组成部分,是一种手段,建议防止用药错误,并解决在墨西哥所有初级保健设施的药学服务实施的紧迫性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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