远程医疗与电话咨询和推医生的药物处方错误:一个集群随机交叉试验
James P Marcin1, Monica K Lieng1, Jamie Mouzoon1
1Department of Pediatrics, University of California School of Medicine, Davis Health, Sacramento.
JAMA network open
|February 29, 2024
概括
与电话咨询相比,视频远程医疗并没有显著减少危急儿童的药物错误. 这项研究强调了进一步研究改善急诊室患者安全的必要性.
科学领域:
- 儿科急救医学 儿科急救医学
- 医疗保健服务研究 医疗服务研究
- 远程医疗远程医疗
背景情况:
- 在非儿科急诊室的重症儿童面临医疗错误,特别是药物错误的高风险.
- 目前的电话咨询可能无法完全减轻这些风险.
- 视频远程医疗为护理提供提供了潜在的进步.
研究的目的:
- 在接受视频远程医疗或电话咨询的重症儿童中,比较医生相关药物错误的发生率.
- 评估视频远程医疗在减少儿科紧急护理中药物错误方面的有效性.
主要方法:
- 一个集群随机,不平衡的交叉试验,涉及15个社区急诊室.
- 15岁以下的重症儿童被随机分配到视频远程医疗或与儿科重症监护医生进行电话咨询.
- 药剂错误被药剂师记录下来,并使用多层次逻辑回归分析.
主要成果:
- 该试验包括696名患者,其中77.2%的患者接受视频远程医疗,22.8%的患者接受电话.
- 与医生相关的药物错误发生在远程医疗和电话组中的12.5%的患者中.
- 对2414个药物订单的分析显示,两种咨询方法之间的错误率没有显著差异 (远程医疗的调整几率比:0.86;95% CI,0.49-1.52).
结论:
- 视频远程医疗咨询并没有显示出与重症儿童的电话咨询相比,医生相关的药物错误的统计显著减少.
- 调查结果表明,视频远程医疗在目前的应用中,可能不会比电话咨询提供实质性的优势,以防止该群体的药物错误.
- 需要进行进一步的研究,以探索通过远程医疗技术提高患者安全和减少急诊室的药物错误的策略.
更多相关视频
07:31Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
Published on: May 15, 2020
7.1K
07:31A Computerized Functional Skills Assessment and Training Program Targeting Technology Based Everyday Functional Skills
Published on: February 13, 2020
6.9K
相关概念视频
Crossover Experiments
2.8K
Crossover experiments, also called the repeated-measurements design, is a study design in which all experimental units are exposed to all treatments in different periods. Crossover experiments are generally used in psychology, the pharmaceutical industry, agriculture, and medicine.
Crossover designs are performed even with smaller sample sizes since the samples can act as their controls. These are better than simple randomized trials since patients are exposed to all the treatments.
Crossover designs are performed even with smaller sample sizes since the samples can act as their controls. These are better than simple randomized trials since patients are exposed to all the treatments.
2.8K
Clinical Trials
6.7K
Clinical trials are prospective experimental studies conducted on humans to determine the safety and efficacy of treatments, drugs, diet methods, and medical devices. Using statistics in clinical trials enables researchers to derive reasonable and accurate conclusions from the collected data, allowing them to make wise decisions in uncertain situations. In medical research, statistical methods are crucial for preventing errors and bias.
There are four phases in a clinical trial. A phase one...
There are four phases in a clinical trial. A phase one...
6.7K
Blinding
2.4K
Blinding is a commonly used method of not telling participants which treatment a subject is receiving. Blinding is a critical part of a randomized control trial or RCT. It reduces the bias that affects the results. In an RCT, blinding is used in the form of a placebo. A placebo effect occurs when untreated subjects falsely believe they have received the treatment and report improved symptoms. A placebo or a dummy treatment is administered to subjects to negate the bias caused by such an effect.
2.4K
Blind Procedures
10.6K
Ideally, the people who observe and record the children’s behavior are unaware of who was assigned to the experimental or control group, in order to control for experimenter bias. Experimenter bias refers to the possibility that a researcher’s expectations might skew the results of the study. Remember, conducting an experiment requires a lot of planning, and the people involved in the research project have a vested interest in supporting their hypotheses. If the observers knew which...
10.6K
Types of Reports III: Telephone and Verbal Reports
741
Telephone and Verbal Reports in healthcare settings are two communication methods for conveying therapeutic instructions from healthcare providers to nurses or other healthcare staff.
Here's an overview of each type:
Telephone Orders
Here's an overview of each type:
Telephone Orders
741
Drug Therapy
43
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
43
