RESUMO
About every second decision of a medical doctor concerns drug therapy. On the basis of a representative Norwegian study, which analyzed fatal drug reactions in stationary patients of internal medicine wards by autopsy and plasma drug concentrations, in Germany 58,000 fatalities are occurring in this patient population. The treating physicians classified only 6% of drug induced fatalities as such. Therefore, the risk of drug therapy is grossly underestimated. In half of the cases medication errors were causative and therefore these could potentially all be avoided. In addition to improved pre- and postgraduate education in clinical pharmacology the use of computer-based expert systems would be a decisive step to optimize drug therapy.
Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos , Quimioterapia Assistida por Computador/métodos , Erros de Medicação/mortalidade , Erros de Medicação/prevenção & controle , Sistemas de Informação em Farmácia Clínica , Alemanha/epidemiologia , Humanos , Incidência , Erros de Medicação/classificação , Erros de Medicação/estatística & dados numéricos , Noruega/epidemiologia , Farmacologia/educação , Medição de Risco , Taxa de SobrevidaRESUMO
OBJECTIVE: Dosing errors are a common source for preventable adverse drug events. This study evaluated the knowledge of German hospital physicians with respect to the daily dosage of frequently used drugs. METHODS: A questionnaire survey was carried out among 168 ward physicians from three university and four municipal hospital departments of internal medicine asking for the daily dosage of 17 frequently used drugs. RESULTS: One hundred twenty-seven of 168 physicians returned a completed questionnaire, a response rate of 75.6%. Only 50% of the dose estimates were within the therapeutic range. Even in cases of frequent prescription 7% of the stated doses were overdosed and 15% were underdosed. CONCLUSIONS: The results of this survey suggest that adverse drug events and the lack of therapeutic effect due to dosing errors could be prevented by an improved knowledge of daily dosages.
Assuntos
Competência Clínica , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Médicos Hospitalares , Preparações Farmacêuticas/administração & dosagem , Prescrições de Medicamentos , Alemanha , Hospitais Municipais , Hospitais Universitários , Humanos , Erros de Medicação , Padrões de Prática Médica , Inquéritos e QuestionáriosRESUMO
AIMS: Ward physicians hold key positions in the course of efforts to reduce drug expenditures in hospitals. This study evaluated the knowledge of German hospital physicians with respect to the daily therapeutic costs of 21 frequently used drugs. METHODS: A questionnaire survey was carried out among 168 ward physicians from university and municipal hospital departments of internal medicine. RESULTS: One hundred and twenty-seven physicians returned a completed questionnaire, a response rate of 75.6%. On average the physicians successfully identified both low cost and expensive drugs. The prices of inexpensive and moderately expensive drugs were generally overestimated whereas those for the expensive and highly expensive drugs were underestimated in 35% and 68% of respondents, respectively. CONCLUSIONS: The results of this survey of German hospital physicians suggest that a more economically efficient use of drugs could be achieved by an improved knowledge of daily therapeutic costs.
