Current status of the monitoring of medication practice

Abstract

Medication practice encompasses the processes of prescribing, dispensing, preparing, administering, and monitoring the clinical effects of medicines. The mission for hospital pharmacy services is to ensure the safe, effective, and economic uses of medicines. Medication practice measures monitor one or more of these elements. Outcome measures providing quantitative data related to the outcomes of health-system performance are the hardest to develop and use in practice. Voluntary medication-error reporting systems provide qualitative information about negative or unsafe outcomes, but the quantitative use of medication error reports should be used with great caution because only a small percentage of incidents will be reported. Trigger tools have recently been developed to enable adverse drug events to be more easily identified and provide a quantitative outcome measure of medication practice. Because outcome measures are difficult to develop and implement in practice, process and structural measures are frequently used to measure medication practice. Measures for unsafe use and negative outcomes of medication are usually used before measures of safe and effective use. Product-defect and adverse-drug-reaction reporting systems comprise the basic elements of pharmacovigilance worldwide. Hospitals and hospital pharmacy services should monitor for incidents of this type, manage the risks locally, and share these data with national and regional pharmacovigilance reporting systems where available.