The effect of prescriber education on medication-related patient harm in the hospital: a systematic review

被引:23
作者
Bos, Jacqueline M. [1 ]
van den Bemt, Patricia M. L. A. [2 ]
de Smet, Peter A. G. M. [3 ,4 ]
Kramers, Cornelis [1 ,5 ]
机构
[1] Canisius Wilhelmina Hosp, Dept Clin Pharm, Weg Door Jonkerbos 100, NL-6532 SZ Nijmegen, Netherlands
[2] Erasmus Univ, Dept Clin Pharm, Med Ctr, Rotterdam, Netherlands
[3] Radboud Univ Nijmegen, Med Ctr, Dept Clin Pharm, Nijmegen, Netherlands
[4] Radboud Univ Nijmegen, Med Ctr, Sci Inst Qual Healthcare, Nijmegen, Netherlands
[5] Radboud Univ Nijmegen, Med Ctr, Dept Clin Pharmacol & Toxicol, Nijmegen, Netherlands
关键词
hospital; medical education; medication errors; patient harm; prescribing; INTENSIVE-CARE-UNIT; ADVERSE DRUG-REACTIONS; JUNIOR DOCTORS; PHARMACOTHERAPY EDUCATION; ERRORS; INTERVENTIONS; PRESCRIPTION; STUDENTS; EVENTS; IMPACT;
D O I
10.1111/bcp.13200
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
AIMS Educating prescribers is a strategy to reduce prescription errors in hospitals. The present systematic review gives an overview of original research papers on the education of prescribers and reporting outcomes on (potential) patient harm. METHODS A search of the databases Embase and Medline, using the Ovid interface, was performed. Research on the effect of physician education in order to prevent medication-related problems in inpatients, and on reporting original data and outcomes on prescribing errors and/or (potential) patient harm, was included. The assessment of methodological quality and risk of bias was performed using theMethodological Index for Non-Randomized studies (MINORS) checklist and the suggested risk of bias criteria for Effective Practice and Organization of Care (EPOC) reviews. RESULTS Eight studies investigated an intervention on education alone, and in seven studies education was the main part of a multifaceted intervention. All studies were small and had short follow-up periods. The educational programmes varied and were given to physicians of different specialties and levels of experience. Most studies reported intermediate process parameters as the outcome. The risk of performance and reporting bias were high. CONCLUSION All included studies suffered from poor methodology. The majority, especially studies in which education was part of a multifaceted intervention, reported effectiveness on intermediate outcome markers as prescription errors and potential adverse drug events. However, we found no firm evidence that educating prescribers in the hospital leads to a decrease in patient harm. Further work is needed to develop educational programmes, accompanied by more high-quality research with outcomes on the improvement of patient care.
引用
收藏
页码:953 / 961
页数:9
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