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首页> 外文期刊>Journal of managed care pharmacy : >Geographic Variation in Drug Safety: Potentially Unsafe Prescribing of Medications and Prescriber Responsiveness to Safety Alerts
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Geographic Variation in Drug Safety: Potentially Unsafe Prescribing of Medications and Prescriber Responsiveness to Safety Alerts

机译：药品安全性的地域差异：潜在的不安全处方药和处方者对安全警示的反应

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BACKGROUND: Drug safety issues represent a major cause of morbidity and mortality. Alerting programs are intended to identify patients at potential risk for adverse drug reactions and may provide relevant information to prescribers to support their decision making about clinically appropriate risk reduction. Geographic differences in the incidence of drug safety issues and the responsiveness of prescribers to alerting systems have not been previously studied.OBJECTIVE: To measure geographic differences in the rates of alerting events for potential drug safety issues, communicated to prescribers by mail or fax, and the responsiveness of prescribers to such alerts.METHODS: All alerts generated by a commercially available drug safety alerting program were evaluated for calendar year 2008 and were classified geographically based on patient residence. Primary study measures were (a) number of alerting events per 1,000 members (i.e., covered beneficiaries of all ages whose plan sponsor was enrolled in the alerting program service), and (b) therapy change rate (defined as the percentage of alerts that were followed by therapy modification consistent with the clinical alert).RESULTS: The program-wide aggregate rate of alerting events across all regions was 128 per 1,000 members, with the state-specific range from 78 to 240. The program-wide aggregate rate of drug therapy change across all regions was 54.0%, with the state-specific range from 48.1% to 59.5%.CONCLUSIONS: The rates of potential drug safety issues (alerting events) and the responsiveness of prescribers to drug safety alerts vary considerably by region and state. States with high issue rates and low therapy change rates may require additional prescriber outreach.
机译：背景：药物安全性问题是发病率和死亡率的主要原因。警报程序旨在识别可能出现药物不良反应风险的患者，并可以向处方者提供相关信息，以支持他们做出有关降低临床风险的决策。目的：通过邮件或传真与处方者沟通，以测量潜在药物安全问题的警报事件发生率的地理差异，以测量药物安全问题的发生地域差异和处方者对警报系统的响应能力。方法：对市售药品安全警报程序产生的所有警报进行评估，评估日期为2008日历年，并根据患者居住地进行地理分类。初步研究措施包括（a）每1,000名成员的警报事件数量（即，计划发起人已加入警报计划服务的所有年龄段的受益人），以及（b）治疗变更率（定义为警报发生率的百分比）结果：该计划范围内所有地区的警报事件总发生率是每1000名成员128次，州特定范围从78到240。所有地区的治疗变化为54.0％，各州的具体变化范围为48.1％至59.5％。结论：潜在的药物安全问题（警报事件）的发生率和处方者对药物安全警报的响应程度因地区和州而异。签发率高而疗法变更率低的州可能需要额外的开处方。

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