Prevalence, contributory factors and severity of medication errors associated with direct-acting oral anticoagulants in adult patients: a systematic review and meta-analysis

被引：28

作者：

Al Rowily, Abdulrhman ^{[1
,2
]}

Jalal, Zahraa ^{[1
]}

Price, Malcolm J. ^{[3
,4
]}

Abutaleb, Mohammed H. ^{[5
]}

Almodiaemgh, Hind ^{[6
]}

Al Ammari, Maha ^{[6
]}

Paudyal, Vibhu ^{[1
]}

机构：

[1] Univ Birmingham, Coll Med & Dent Sci, Sir Robert Aitken Inst Med Res, Inst Clin Sci,Sch Pharm, Birmingham B15 2TT, W Midlands, England

[2] King Fahad Mil Med Complex KFMMC, Med Dept, Minist Def, Pharmaceut Care Dept, Dhahran, Saudi Arabia

[3] Univ Birmingham, Inst Appl Hlth Res, Birmingham, W Midlands, England

[4] Univ Hosp Birmingham NHS Fdn Trust, NIHR Birmingham Biomed Res Ctr, Birmingham, W Midlands, England

[5] Minist Hlth, Pharmaceut Care Dept, King Fahad Cent Hosp, Jazan, Saudi Arabia

[6] King Saud Bin Abdulaziz Univ Hlth Sci, King Abdullah Int Med Res Ctr, King Abdulaziz Med City, Pharmaceut Care Dept, Riyadh, Saudi Arabia

来源：

EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY | 2022年 / 78卷 / 04期

关键词：

Non-vitamin K antagonist oral anticoagulants; Direct acting oral anticoagulants (DOACs); Medication errors; Systematic review; Meta-analysis; DABIGATRAN; RIVAROXABAN; CARE;

D O I：

10.1007/s00228-021-03212-y

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Purpose This study aimed to estimate the prevalence, contributory factors, and severity of medication errors associated with direct acting oral anticoagulants (DOACs). Methods A systematic review and meta-analysis were undertaken by searching 11 databases including Medline, Embase, and CINHAL between January 2008 and September 2020. The pooled prevalence of errors and predictive intervals were estimated using random-effects models using Stata software. Data related to error causation were synthesised according to Reason's accident causation model. Results From the 5205 titles screened, 32 studies were included which were mostly based in hospitals and included DOAC treatment for thromboembolism and atrial fibrillation. The proportion of study population who experienced either prescription, administration, or dispensing error ranged from 5.3 to 37.3%. The pooled percentage of patients experiencing prescribing error was 20% (95% CI 15-25%; I-2 = 96%; 95% PrI 4-43%). Prescribing error constituted the majority of all error types with a pooled estimate of 78% (95%CI 73-82%; I-2 = 0) of all errors. The common reported causes were active failures including wrong drug, and dose for the indication. Mistakes such as non-consideration of renal function, and error-provoking conditions such as lack of knowledge were common contributing factors. Adverse events such as potentially fatal intracranial haemorrhage or patient deaths were linked to the errors but causality assessments were often missing. Conclusions Despite their favourable safety profile, DOAC medication errors are common. There is a need to promote multidisciplinary working, guideline-adherence, training, and education of healthcare professionals, and the use of theory-based and technology-facilitated interventions to minimise errors and maximise the benefits of DOACs usage in all settings. Protocol A protocol developed as per PRISMA-P guideline is registered under PROSPERO ID = CRD42019122996

引用

页码：623 / 645

页数：23

共 55 条

[1]

Ageno W, 2013, J THROMB HAEMOST, V11, P151, DOI [10.1111/jth.12234, 10.1111/jth.12038]

[2] Assessment of novel oral anticoagulant use within a community teaching hospital [J].