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Dasaro CR, Sabra A, Jeon Y, Williams TA, Sloan NL, Todd AC, Teitelbaum SL. A comparison of two user-friendly methods to identify and support correction of misspelled medications. Prev Med Rep 2024; 43:102765. [PMID: 38798907 PMCID: PMC11127154 DOI: 10.1016/j.pmedr.2024.102765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 04/29/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
Objective To identify and support correction of misspelled medication names recorded as free text, we compared the relative effectiveness of two user-friendly methods, used without reliance on clinical knowledge. Methods Leveraging the SAS® COMPGED function, fuzzy string search programs examined 1.8 million medication records from 183,600 World Trade Center General Responder Cohort monitoring visits conducted in New York and New Jersey between 7/16/2002 and 3/31/2021, producing replicable generalized edit distance scores between the reported and correct spelling. Scores < 120 were selected as optimal and compared to Stedman's 2020 Plus Medical/Pharmaceutical Spell Checker first suggested word, used as the comparative standard because it employs both spelling and phonetic similarities to suggest matching words. We coded each methods' results as identifying or not identifying the medications within each visit. Results Most types of medications (94.4 % anxiety, 98.4 % asthma and 94.6 % ulcer/gastroesophageal reflux disease) were correctly spelled. Cross tabulations assessed the agreement (anxiety 99.9 %, asthma 99.6 % and 98.4 % ulcer/ gastroesophageal reflux disease), false positive (respectively 0.02 %, 0.03 % and 2.0 %) and false negative (respectively 1.9 %, 0.5 % and 1.0 %) values. Scores < 120 occasionally correctly identified medications missed by the spell checker. We observed no difference in medication misspellings across socio-economically and culturally diverse patient characteristics. Conclusions Both methods efficiently identified most misspelled medications, greatly minimizing the review and rectification needed. The fuzzy method is more universally applicable for condition-specific medications identification, but requires more programming skills. The spell checker is inexpensive, but benefits from modest programming skills and is only available in some languages.
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Affiliation(s)
- Christopher R. Dasaro
- World Trade Center Health Program General Responder Data Center, Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, 2 Floor, New York, NY 10029, United States of America
| | - Ahmad Sabra
- World Trade Center Health Program General Responder Data Center, Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, 2 Floor, New York, NY 10029, United States of America
| | - Yunho Jeon
- World Trade Center Health Program General Responder Data Center, Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, 2 Floor, New York, NY 10029, United States of America
| | - Tankeesha A. Williams
- World Trade Center Health Program General Responder Data Center, Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, 2 Floor, New York, NY 10029, United States of America
| | - Nancy L. Sloan
- World Trade Center Health Program General Responder Data Center, Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, 2 Floor, New York, NY 10029, United States of America
| | - Andrew C. Todd
- World Trade Center Health Program General Responder Data Center, Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, 2 Floor, New York, NY 10029, United States of America
| | - Susan L. Teitelbaum
- World Trade Center Health Program General Responder Data Center, Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, 2 Floor, New York, NY 10029, United States of America
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Wat SKS, Wesolowski B, Cierniak K, Roberts P. Assessing the impact of an electronic chemotherapy order verification checklist on pharmacist reported errors in oncology infusion centers of a health-system. J Oncol Pharm Pract 2023:10781552231223511. [PMID: 38151027 DOI: 10.1177/10781552231223511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
PURPOSE Chemotherapies are medications with narrow therapeutic indices and potential for severe adverse events that account for at least 1 to 3% of medication errors in all adult and pediatric oncology patients. The use of an electronic chemotherapy order verification (ECOV) checklist can standardize the steps of chemotherapy verification by pharmacists, which can potentially increase medication error detection at the point of dispensing. This study evaluated the implementation of a standardized chemotherapy order verification checklist on pharmacist error reporting, particularly good-catches or near-misses type errors. METHODS This retrospective, quasi-experimental, pre-/post-analysis of internal voluntary medication errors reported from 12 University Hospitals Seidman oncology infusion centers from June 2022 through December 2022. Error reports, categorized based on severity, were compared pre/post-implementation of the ECOV checklist. RESULTS A total of 62 and 71 cases of medication errors were reported in the pre-intervention and post-intervention periods, respectively. The rate of pharmacy reported medication errors was 2.4 times greater in the post-intervention period of the ECOV checklist (p < 0.006). Pharmacy reported errors increased among all error severities reported. However, the finding did not deduce a statistically significant difference (p < 0.244). CONCLUSION This study demonstrates the effectiveness of implementing the ECOV checklist in increasing the rate of pharmacy reported medication errors. The checklist was designed to complement existing pharmacist workflow and provide a source of documentation for steps of sequential pharmacist evaluation.
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Affiliation(s)
| | - Bryan Wesolowski
- Department of Pharmacy Service, University Hospitals, Cleveland OH, USA
| | - Kayla Cierniak
- Department of Pharmacy Service, University Hospitals, Cleveland OH, USA
| | - Patricia Roberts
- Department of Pharmacy Service, University Hospitals, Cleveland OH, USA
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Stonerock DS, Clark K, Shah V, Irvine CC, Draper E, Soefje SA. Evaluating the Impact of Pharmacist Dual Verification of Anticancer Therapy in the Modern Era. J Pharm Technol 2023; 39:281-285. [PMID: 37974597 PMCID: PMC10640867 DOI: 10.1177/87551225231197346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Background: Pharmacist order verification is a critical step in ensuring medication safety for patients. While the second pharmacist verification (SPV) before dispensing anticancer therapies has been a longstanding practice, its continued necessity in the context of modern electronic health systems lacks robust evidence. Objective: This study aimed to assess the frequency of interventions performed by a second pharmacist to determine the ongoing effectiveness of the SPV process. Methods: This retrospective chart review was conducted at the Mayo Clinic, encompassing all anticancer therapy orders that necessitated an SPV. The study period extended from January 1, 2019, to June 30, 2021, and included inpatient and outpatient anticancer orders. The quantification and reporting of alterations made to discrete order fields subsequent to initial pharmacist verification of clinical significance were performed, utilizing the total number of anticancer therapy orders as the denominator. Results: Approximately 300 000 anticancer therapy orders were screened for inclusion criteria and 2.6% (N = 7634) of orders were modified on the SPV. Most changes were in the categories of rate (N = 1962), order start time (N = 1219), and pharmacy communication note (N = 777). Dosing changes greater than 10% accounted for 0.03% (N = 99) of the orders, with 10 anticancer therapies responsible for more than 50% of these changes. Conclusion and relevance: This study represents the largest report on the impact of SPV in a modern era. Our results suggest the SPV may be valuable for a small proportion of chemotherapy orders but raises questions about the necessity for broad application of this practice.
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Affiliation(s)
| | - Kaylee Clark
- Department of Pharmacy, Mayo Clinic, Rochester, MN, USA
| | - Vishal Shah
- Department of pharmacy, Mayo Clinic, Phoenix, AZ, USA
| | | | - Evan Draper
- Department of Pharmacy, Mayo Clinic, Rochester, MN, USA
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Alenoghena CO, Onumanyi AJ, Ohize HO, Adejo AO, Oligbi M, Ali SI, Okoh SA. eHealth: A Survey of Architectures, Developments in mHealth, Security Concerns and Solutions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13071. [PMID: 36293656 PMCID: PMC9603507 DOI: 10.3390/ijerph192013071] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
The ramifications of the COVID-19 pandemic have contributed in part to a recent upsurge in the study and development of eHealth systems. Although it is almost impossible to cover all aspects of eHealth in a single discussion, three critical areas have gained traction. These include the need for acceptable eHealth architectures, the development of mobile health (mHealth) technologies, and the need to address eHealth system security concerns. Existing survey articles lack a synthesis of the most recent advancements in the development of architectures, mHealth solutions, and innovative security measures, which are essential components of effective eHealth systems. Consequently, the present article aims at providing an encompassing survey of these three aspects towards the development of successful and efficient eHealth systems. Firstly, we discuss the most recent innovations in eHealth architectures, such as blockchain-, Internet of Things (IoT)-, and cloud-based architectures, focusing on their respective benefits and drawbacks while also providing an overview of how they might be implemented and used. Concerning mHealth and security, we focus on key developments in both areas while discussing other critical topics of importance for eHealth systems. We close with a discussion of the important research challenges and potential future directions as they pertain to architecture, mHealth, and security concerns. This survey gives a comprehensive overview, including the merits and limitations of several possible technologies for the development of eHealth systems. This endeavor offers researchers and developers a quick snapshot of the information necessary during the design and decision-making phases of the eHealth system development lifecycle. Furthermore, we conclude that building a unified architecture for eHealth systems would require combining several existing designs. It also points out that there are still a number of problems to be solved, so more research and investment are needed to develop and deploy functional eHealth systems.
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Affiliation(s)
| | - Adeiza James Onumanyi
- Next Generation Enterprises and Institutions, Council for Scientific and Industrial Research (CSIR), Pretoria 0001, South Africa
| | - Henry Ohiani Ohize
- Department of Telecommunication Engineering, Federal University of Technology, Minna P.M.B. 65, Nigeria
| | - Achonu Oluwole Adejo
- Department of Telecommunication Engineering, Federal University of Technology, Minna P.M.B. 65, Nigeria
| | - Maxwell Oligbi
- Department of Telecommunication Engineering, Federal University of Technology, Minna P.M.B. 65, Nigeria
| | - Shaibu Ibrahim Ali
- Department of Telecommunication Engineering, Federal University of Technology, Minna P.M.B. 65, Nigeria
| | - Supreme Ayewoh Okoh
- Department of Telecommunication Engineering, Federal University of Technology, Minna P.M.B. 65, Nigeria
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Rai A, Keil M, Choi H, Mindel V. Understanding how physician perceptions of job demand and process benefits evolve during CPOE implementation. Health Syst (Basingstoke) 2022; 12:98-122. [PMID: 36926371 PMCID: PMC10013386 DOI: 10.1080/20476965.2022.2113343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 08/03/2022] [Indexed: 10/14/2022] Open
Abstract
We examine how physicians' perceptions of two computerized provider order entry (CPOE) capabilities, standardisation of care protocols and documentation quality, are associated with their perceptions of turnaround time, medical error, and job demand at three phases of CPOE implementation: pre-go-live, initial use, and continued use. Through a longitudinal study at a large urban hospital, we find standardisation of care protocols is positively associated with turnaround time reduction in all phases but positively associated with job demand increase only in the initial use phase. Standardisation also has a positive association with medical error reduction in the initial use phase, but later this effect becomes fully mediated through turnaround time reduction in the continued use phase. Documentation quality has a positive association with medical error reduction in the initial use phase and this association strengthens in the continued use phase. Our findings provide insights to effectively manage physicians' response to CPOE implementation.
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Affiliation(s)
- Arun Rai
- Georgia State University, Atlanta, Georgia, United States
| | - Mark Keil
- Georgia State University, Atlanta, Georgia, United States
| | - Hyoungyong Choi
- Hankuk University of Foreign Studies, Dongdaemun-gu, Seoul, Korea
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Fong A, Kazi S, Kazanas M, Ratwani RM, Hettinger AZ. Estimating the frequency of automated dispensing cabinet discrepancy safety events using Markov models. DRUGS & THERAPY PERSPECTIVES 2022. [DOI: 10.1007/s40267-022-00900-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Millares Martin P. Reducing medication errors still needs a health informatics solution in clinical practice. HEALTH AND TECHNOLOGY 2022. [DOI: 10.1007/s12553-022-00644-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kassem AB, Saeed H, El Bassiouny NA, Kamal M. Assessment and analysis of outpatient medication errors related to pediatric prescriptions. Saudi Pharm J 2021; 29:1090-1095. [PMID: 34703362 PMCID: PMC8523327 DOI: 10.1016/j.jsps.2021.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 08/01/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Medication errors are the errors that impact the efficacy and safety of the therapy. The impact of medication errors is higher for certain subjects, such as pediatrics, who require more attention. Hence, the current study aimed to investigate the types and frequency of outpatient medication errors of pediatric subjects related to different prescription types. METHODS A cross-sectional study was carried in several community pharmacies to record the medication errors found in outpatient pediatric prescriptions by gathering data from the outpatient prescriptions besides direct counseling with the subjects and their parents. Many medical resources (disease and drug-related) were used for checking the different aspects of medication errors. The data collection process included a preprepared sheet containing several items representing the medication errors in addition to a counseling session. Data were expressed as percentages and compared through the Chi-square test for results of handwritten and computerized prescriptions. RESULTS 752 outpatient pediatric prescriptions were recruited in the study as they involve medication errors. Among the highest percentage of medication errors was the absence of essential data in the prescription, such as diagnosis, age, and weight. The duration of the therapy and contraindication for some of the prescribed medications were among the highest recorded errors. Among the critical errors were the drug interaction and drug duplication that directly affect the drug's efficacy and safety. There was a significant difference between computerized and handwritten prescriptions regarding the number of medication errors related to each type. CONCLUSION Medication errors related to outpatient pediatric prescriptions vary from one to another prescription with predominant errors that influence the therapy's safety or efficacy. The role of patient counseling and prescription checking is critical for improving patient therapy.
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Affiliation(s)
- Amira B. Kassem
- Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Damanhour University, Egypt
| | - Haitham Saeed
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Noha A. El Bassiouny
- Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Damanhour University, Egypt
| | - Marwa Kamal
- Clinical Pharmacy Department, Faculty of Pharmacy, Fayoum University, Fayoum, Egypt
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