Improving medication safety for medically complex children with mHealth across caregiving networks

通过跨护理网络的移动医疗提高病情复杂的儿童的用药安全

• 批准号: 10616759
• 负责人: Ryan J Coller
• 金额: $ 50万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-02 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10616759
• 关键词: Improving; medication; safety; medically; complex

PROJECT SUMMARY Children with medical complexity (CMC) are uniquely vulnerable to medication errors and adverse drug events because of their extreme polypharmacy, underlying medical fragility, and reliance on complicated medication schedules and routes. CMC have 5 times higher odds of an adverse drug event leading to an Emergency Department (ED) visit than other children. Over 1 of 50 CMC ED visits are due to adverse drug events, and 38% of CMC ED visits for adverse drug events result in hospital admission. Having accurate knowledge to accurately give high-risk medications is an absolute requirement for safe medication management. Prior work observed that medication administration accuracy, i.e., knowing indication, formulation, dose, frequency, and route of administration, was successfully described by fewer than half of CMC caregivers. Low medication administration accuracy leads to adverse drug events, including potentially preventable hospitalizations, emergency department visits, and morbidity. Currently, no tools exist to support families of CMC to ensure high medication administration accuracy across their network of “secondary” caregivers involved in CMC daily care (e.g., family, in-home care professionals, school caregivers, etc.). To address these critical unmet needs, we will create a mobile health (mhealth) platform, Medication Safety @HOME (MedS@HOME) to improve CMC medication safety by supporting standardized medication management across the caregiving network. We anticipate that MedS@HOME will increase medication administration accuracy and reduce medication-related adverse events, and ultimately improve chronic care management through the creation and promotion of standardized medication management practices across the caregiving network. To achieve this goal, we propose to conduct the following aims: 1) Design the MedS@HOME intervention through participatory co- design with stakeholders in a parallel design process with three design teams: one with primary CMC caregivers, one with secondary caregivers, and one with experts in medication safety and CMC clinical care; 2) Evaluate the effectiveness of MedS@HOME on medication administration accuracy of high-risk medications (e.g., antiepileptic drugs, opioids) in a randomized controlled trial, testing the hypothesis that medication administration accuracy is improved for primary and secondary caregivers with use of MedS@HOME. Completion of the aims will result in a scalable mhealth intervention that improves medication safety for CMC across the caregiving network. MedS@HOME, when perfected, can improve medication safety and chronic care management across the wide range of populations that depend on caregiving networks.

项目摘要 患有医疗复杂性的儿童（CMC）独特容易受到药物错误和不良药物事件的攻击 由于其极端的多药，基本的医疗脆弱性以及依赖复杂的药物 时间表和路线。 CMC的不良药物事件的几率高出5倍，导致紧急情况 部门（ED）访问比其他孩子。超过50个CMC ED访问中的1多次是由于道歉毒品事件，并且 38％的CMC ED访问广告毒品事件导致住院。具有准确的知识 准确地提供高风险药物是安全药物管理的绝对要求。先前的工作 观察到药物给药精度，即知道指示，配方，剂量，频率和 行政途径是由不到一半的CMC护理人员成功描述的。药物低 管理准确性导致不良药物事件，包括潜在的预防住院， 急诊室就诊和发病率。目前，尚无支持CMC家族以确保高高的工具 涉及CMC Daily Care的“次级”护理人员网络的药物管理精度 （例如，家庭，家庭护理专业人员，学校护理人员等）。为了满足这些关键的未满足需求，我们 将创建一个移动健康（MHealth）平台，药物安全@Home（Meds @home），以改善CMC 通过支持整个护理网络的标准化药物管理，药物安全。我们 预计Meds@Home将提高药物管理的准确性并降低与药物有关 不利事件，并最终通过创建和促进来改善慢性护理管理 整个护理网络的标准化药物管理实践。为了实现这一目标，我们 提出以下目的的建议：1）通过参与共同设计Meds@家庭干预 与利益相关者在平行设计过程中与三个设计团队的设计：一个主要CMC 护理人员，一名患有中学护理人员，一位拥有药物安全和CMC临床护理专家； 2） 评估Meds@Home在药物管理高风险药物准确性上的有效性 （例如，抗癫痫药，阿片类药物）在一项随机对照试验中，检验了药物的假设 使用MEDS@Home使用Meds@Home提高了管理和次要护理人员的准确性。 目的的完成将导致可扩展的MHealth干预措施，以提高CMC的药物安全性 整个护理网络。 Meds@Home，完善后可以提高药物安全性和慢性 依赖护理网络的广泛人群的护理管理。