Background

Medicine self-administration errors (MSEs) are a longstanding issue in patient safety. Although many studies have examined MSEs in the general adult population, the MSEs that occur specifically in the older adult population and their contributing factors are not well understood.

Objective

To identify the types of MSEs and their contributing factors among community-dwelling older adults.

Methods

PubMed, Medline, Embase, CINAHL and Scopus were searched for primary studies published between January 1, 2014 and June 12, 2020. Studies which reported MSEs among community-dwelling older adults (≥50 years of age) and written in English were included in the review.

Results

Eleven studies met the inclusion criteria. The most commonly reported MSE was a dosing error, followed by missed dose, wrong medicine, incorrect administration methods, wrong administration time and wrong frequency. Seven of the included studies also described factors which contributed to the occurrence of MSEs. The most commonly reported factor contributing to MSEs was complex treatment regimens due to use of multiple medicines. Other factors identified included cognitive decline, decline in physical abilities, lack of social support, lack of knowledge about treatment regimens and negative attitudes and beliefs towards medicines. In most cases, MSEs occurred when multiple contributing factors were present.

Conclusion

The literature highlights a number of types of MSEs and their contributing factors which occur in the older adult population. Given that many MSEs are preventable, future research is needed into how pharmacists can support the identification and mitigation of factors contributing to MSEs in the older adult population.

中文翻译：

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老年人群中的药物自我管理错误：系统评价

背景

药物自我管理错误 (MSE) 是患者安全方面的一个长期问题。尽管许多研究已经检查了一般成年人群中的 MSE，但对老年人群中特别发生的 MSE 及其影响因素尚不清楚。

客观的

确定社区老年人中 MSE 的类型及其影响因素。

方法

检索了 PubMed、Medline、Embase、CINAHL 和 Scopus 中发表于 2014 年 1 月 1 日至 2020 年 6 月 12 日之间的主要研究。报告社区居住的老年人（≥50 岁）的 MSE 并用英文撰写的研究被纳入评价。

结果

11 项研究符合纳入标准。最常见的 MSE 是给药错误，其次是漏服、错误用药、错误给药方法、错误给药时间和错误频率。七项纳入的研究还描述了导致 MSE 发生的因素。最常报告的导致 MSE 的因素是由于使用多种药物而导致的复杂治疗方案。确定的其他因素包括认知能力下降、身体能力下降、缺乏社会支持、缺乏对治疗方案的了解以及对药物的消极态度和信念。在大多数情况下，当存在多种影响因素时，就会发生 MSE。

结论

文献强调了许多类型的 MSE 及其在老年人群中发生的影响因素。鉴于许多 MSE 是可以预防的，未来需要研究药剂师如何支持识别和减轻导致老年人群 MSE 的因素。