Look-alike, Sound-alike Research Articles

Medicamentos Potencialmente Perigosos: Como Garantir a sua Segurança no Hospital

Os medicamentos de alerta máximo são caracterizados por um risco acrescido de provocar dano significativo ao doente em consequência de falhas no seu processo de utilização. Neste sentido, este artigo de revisão procura de-finir procedimentos para reduzir o risco de erros associados à utilização de medicamentos look-alike, sound-alike (LASA) e concentrados eletrolíticos. Os profissionais de saúde, doentes e seus cuidadores devem ser formados e elucidados sobre os medicamentos de alerta máximo.

Using drug knowledgebase information to distinguish between look-alike-sound-alike drugs.

To extract drug indications from a commercial drug knowledgebase and determine to what extent drug indications can discriminate between look-alike-sound-alike (LASA) drugs. We extracted drug indications disease concepts from the MedKnowledge Indications module from First Databank Inc. (South San Francisco, CA) and associated them with drugs on the Institute for Safe Medication Practices (ISMP) list of commonly confused drug names. We used high-level concepts (rather than granular concepts) to represent the general indications for each drug. Two pharmacists reviewed each drug's association with its high-level indications concepts for accuracy and clinical relevance. We compared the high-level indications for each commonly confused drug pair and categorized each pair as having a complete overlap, partial overlap or no overlap in high-level indications. Of 278 LASA drug pairs, 165 (59%) had no overlap and 58 (21%) had partial overlap in high-level indications. Fifty-five pairs (20%) had complete overlap in high-level indications; nearly half of these were comprised of drugs with the same active ingredient and route of administration (e.g., Adderall, Adderall XR). Drug indications data from a drug knowledgebase can discriminate between many LASA drugs.

The performance improvement of look-alike sound-alike drug pre-dispensing

Medical dispensing errors are common and classic human errors in the hospitals. Look-alike, Sound-alike (LASA) drug is one of the main issues in pre-dispensing and dispensing processes. The data in this study were observed from one middle size hospital in Thailand. In 2017, there were two months that the medication errors KPI (0.065 and 0.061) were greater than the accepted error threshold (0.06). The SBAR (Situation, Background, Assessment, and Recommendation) solution and HOSxP software were applied for three months in the pre-dispensing process to reduce the medical dispensing errors. The results showed that the medication errors KPI (0.04, 0.03, and 0.02, respectively) were reduced dramatically. Therefore, implementation of the SBAR and HOSxP software is recommended as a fast and easy solution for medical dispensing errors.

A Framework of Rebalancing Imbalanced Healthcare Data for Rare Events' Classification: A Case of Look-Alike Sound-Alike Mix-Up Incident Detection.

Identifying rare but significant healthcare events in massive unstructured datasets has become a common task in healthcare data analytics. However, imbalanced class distribution in many practical datasets greatly hampers the detection of rare events, as most classification methods implicitly assume an equal occurrence of classes and are designed to maximize the overall classification accuracy. In this study, we develop a framework for learning healthcare data with imbalanced distribution via incorporating different rebalancing strategies. The evaluation results showed that the developed framework can significantly improve the detection accuracy of medical incidents due to look-alike sound-alike (LASA) mix-ups. Specifically, logistic regression combined with the synthetic minority oversampling technique (SMOTE) produces the best detection results, with a significant 45.3% increase in recall (recall = 75.7%) compared with pure logistic regression (recall = 52.1%).

Exploring the potential for using drug indications to prevent look-alike and sound-alike drug errors

ABSTRACTBackground: Look-alike, sound-alike (LASA) drug names are a cause of medication errors with resulting patient harm and healthcare costs. This study assessed to which extent the use of the generic drug name, therapeutic class, health problem, and the U.S. Food and Drug Administration (FDA)-approved indications might be used to differentiate LASA drug pairs.Research design and methods: We collected information about LASA drug pairs reported by the FDA to have look-alike sound-alike similarities. To assess potential for differentiating LASA drug pairs, we compared the following drug characteristics: generic name, therapeutic class, health problem, and FDA-approved indication.Results: For the 33 FDA reported LASA drug pairs we identified a total of 432 FDA-approved indications. Using the generic name, therapeutic class, health problem and drug indication we were able to differentiate 8 (24.2%), 24 (72.7%), 25 (75.8%) and 26 (78.8%), respectively of the 33 LASA drug pairs. Using the generic name, therapeutic class, and health problem we were able to distinguish 31 (7.2%), 212 (49.1%), and 269 (62.3%), respectively of the 432 FDA-approved indications for the LASA drug pairs.Conclusions: Including the FDA-approved indication in the drug prescription may be used to differentiate LASA drug pairs and thus, prevent wrong drug medication errors.

An assessment of the basic medication safety practices in Khartoum State hospitals

PurposeTo assess the presence of medication safety practices in Khartoum State hospitals.MethodsA previously used questionnaire was used to evaluate medication safety practices. The main practices evaluated were the presence of...

Potential Hazards of Illegible Prescription: Look Alike Sound Alike Trade and Generic Names

Objective: In India, where market has thousands of trade name medicines and prescriptions of doctors are usually in illegible handwriting there is high probability of dispensing and medication errors due to look-alike sound-alike (LASA) trade names. This study is an attempt to correlate doctor's handwriting and confusion of trade name to develop a help list of confusing product names. Methodology: A total of 5472 prescriptions presented for dispensing during a period of six months were studied and analyzed to determine and identify the confusing trade names, so as to design a ready made list of such products which will serve as a cautionary reference for avoiding dispensing errors. Findings: Potentially confusing trade name pairs of medicines available in local market of Andhra Pradesh, India were paired out and categorized. A list of 55 pairs of almost identical trade names was compiled, which shall serve as a ready reference for pharmacists while dealing such prescriptions. The list has been arranged alphabetically for ease of reference. Practical implications: It recommends three step audit of prescription before final dispensing to avoid any potential error. Originality/value: This research shall have direct implication on reducing chances of wrong dispensing due to poor/illegible handwriting of doctors. Conclusion: Several trade names are almost identical orthographically or phonologically with very minor difference in spelling but having entirely different pharmacological, therapeutic and toxic effects. Preventing such possible confusion during dispensing of prescription shall have great medical and social value. The help list developed shall serve as a ready reckoner for safe dispensing of prescriptions.

Tall Man lettering and potential prescription errors: a time series analysis of 42 children's hospitals in the USA over 9 years

BackgroundDespite the widespread implementation of Tall Man lettering, little evidence exists regarding whether this technique has reduced drug errors due to look-alike sound-alike (LA-SA) drug names. This study evaluated rates...

Case report of a medication error by look-alike packaging: a classic surrogate marker of an unsafe system

BackgroundThe acronym LASA (look-alike sound-alike) denotes the problem of confusing similar- looking and/or sounding drugs accidentally. The most common causes of medication error jeopardizing patient safety are LASA as well as high workload.Case presentationA critical incident report of medication errors of opioids for postoperative analgesia by look-alike packaging highlights the LASA aspects in everyday scenarios. A change to a generic brand of medication saved costs of up to 16% per annum. Consequently, confusion of medication incidents occurred due to the similar appearance of the newly introduced generic opioid. Due to consecutive underdosing no life-threatening situation arose out of this LASA based medication error.ConclusionsCurrent recommendations for the prevention of LASA are quite extensive; still, in a system with a lump sum payment per case not all of these security measures may be feasible. This issue remains to be approached on an individual basis, taking into consideration local set ups as well as financial issues.Electronic supplementary materialThe online version of this article (doi:10.1186/s13037-014-0047-0) contains supplementary material, which is available to authorized users.

GRP-020 Analysis of Italian Hospital Pharmacist Activities to Prevent LASA Drug Errors in Treatment: First Results

BackgroundErrors caused by the use of Look-Alike/Sound-Alike (LASA) drugs occur with high frequency in hospital departments. In August 2010 the Italian Ministry of Health passed a Recommendation to help health...

English

A cross-sectional survey was designed to study look-alike, sound-alike (LASA) drugs in hospitals in Thailand. The questionnaires were developed and mailed to 1,380 hospitals throughout Thailand. The return rate was 11.16% or 154 hospitals, consisting of 5 tertiary hospitals (3.25%), 3 university hospitals (1.95%), 16 secondary hospitals (10.39%), 96 primary hospitals (62.34%), 26 private hospitals (16.88%) and 8 others (5.20%). A total of 5,327 pairs of drugs were identified as LASA drugs, including 3,695 tablets/capsules (Ranitidine-Roxithromycin pair in the highest frequency), 944 injections (Diazepam-Furosemide pair in the highest frequency), 307 liquid dosage forms (Alum milk-Milk of magnesia pair in the highest frequency), 367 external drugs (0.02% Triamcinolone cream and 0.1% Triamcinolone cream pair in the highest frequency) and 14 pairs of chemotherapeutic agents. This LASA report could be integrated into a suitable program used in hospitals in order to identify and prevent medication errors in the future.   Key words: Look-alike, sound-alike, look-alike, sound-alike (LASA), hospital, Thailand.

Medication safety practices in hospitals: A national survey in Saudi Arabia

BackgroundMedication errors in hospitals are a worldwide concern. The World Health Organization has recommended the implementation of basic applications in healthcare systems to improve medication safety, but it is largely unknown whether these recommendations are adhered to by hospitals. We assessed the presence of core medication safety practices in Saudi Arabian hospitals. MethodsWe developed and validated a survey to assess medication safety practices in hospitals. Major headings included Look-Alike Sound-Alike (LASA) medications, control of concentrated electrolyte solutions, transitions in care, information technology, drug information and other medication safety practices. Trained pharmacists visited samples of hospitals from all regions of Saudi Arabia. ResultsSeventy-eight hospitals were surveyed. Only 30% of the hospitals had a medication safety committee and 9% of hospitals had a medication safety officer. Only 33% of hospitals had a list of LASA medications and 50% had a list of error-prone abbreviations. Concentrated electrolytes were available in floor stock in 60% of the hospitals. No hospital involved pharmacists in obtaining medication histories and only 37% of the hospitals provided a medication list to the patients at discharge. While 61% of hospitals used a computer system in their pharmacy to enter prescriptions, only 29% of these hospitals required entry of patient’s allergies before entering a drug order. ConclusionsCore practices to improve medication safety were not implemented in many hospitals in Saudi Arabia. In developing countries, an effort must be made at the national level to increase the adoption of such practices.

Nurses perceived problems with ‘high-alert drugs’: results from the European Institute of Oncology†

BackgroundPatients' growing interest in maintaining their own health and quality of life can certainly be linked to a significant increase in their knowledge of their rights. The Italian Ministry has...

Using Pharmacy Data to Screen for Look-Alike, Sound-Alike Substitution Errors in Pediatric Prescriptions

The aim of this study was to pilot test a screening approach to detect potential look-alike, sound-alike (LASA) errors in pediatric outpatient prescriptions. Medicaid pharmacy claims from one state were reviewed. From a list of LASA drug pairs, we identified candidate pairs meeting the following criteria: 1) one drug was commonly prescribed in children; 2) the paired drug was uncommonly prescribed for children; and 3) both drugs were available as oral preparations only, resulting in 11 LASA pairs. We identified patients who usually received one drug in a pair, then presented with a first dispensing of the paired drug, representing a "screening alert" for potential LASA error. We determined a "true error" as any patient who triggered a screening alert, received only one dispensing of the paired drug in the subsequent 6 months, and had no diagnoses supporting the dispensing of the paired drug. Among the 22 test drugs, there were 1 420 091 prescriptions to 173 005 subjects. There were 395 screening alerts generated, representing a screening alert frequency of 0.28 screening alerts per 1000 prescriptions. We identified 43 true LASA errors. In the dataset, the overall LASA error rate is estimated to be approximately 0.00003%, or 0.03 LASA errors per 1000 prescriptions. Prescription dispensing patterns can be used to screen for LASA errors in pediatric prescriptions. The rates of pediatric LASA errors appear to be much lower than other types of pediatric medication errors and may be best addressed by automated processes.

Look-alike, sound-alike drugs in oncology

Medication errors with oncology drugs can place cancer patients at risk for adverse events or death. Look-alike, sound-alike (LASA) drug names may increase the risk for errors. Published lists of LASA drug names are generally a result of voluntarily reported medication incidents. This study performed a proactive review of the oncology drug formulary from the Cancer Services of the Alberta Health Services for LASA drug pairs. The Levenshtein Distance and Bigram Similarity algorithms, same first and last letters, and Lexi-Comp(R) on-line alerts were used to review the outpatient oncology formulary to identify potential LASA generic drug name pairs. indicate there are more potential LASA generic drug name pairs in the oncology formulary than are published in the literature. The risk detection methods used in this study identified unique and common LASA drug pairs. The Bigram Similarity algorithm identified 186 LASA drug pairs from 3320 possible pairs. The Levenshtein Distance algorithm, same first and last letters, and Lexi-Comp(R) methods identified 42, 75, and 38 LASA drug pairs, respectively. Five generic LASA drug pairs were identified in common by all four of the risk determination methods. LASA drug pairs identified by three or four methods were considered to provide the highest risk for errors. A step-wise approach to risk reduction, dependent on the number of detection methods identifying a pair, is presented. For specialty areas of practice, a proactive system of reviewing LASA drug name pairs may be warranted for increasing medication safety.

Successful Introduction of Tallman Letters to Reduce Medication Selection Errors in a Hospital Network

ABSTRACTAimTo implement Tallman letters into the medication selection process at a hospital network, including dispensing and drug administration, to reduce errors associated with look‐alike sound‐alike (LASA) drugs.MethodThe 3 phases of the study were overseen by a working party consisting of pharmacists at the Alfred Hospital (May 2006 to May 2008). The 3 phases consisted of piloting Tallman letters in the pharmacy department, developing a LASA drug list appropriate to the hospital network, and implementing Tallman letters into the hospital network's medication selection process.ResultsA short LASA drug list was piloted in the inpatient dispensary for 6 months. When this was considered successful, a comprehensive LASA drug list was developed that consisted of 51 items to distinguish between generic names (n = 41), brand names (n = 6) and generic and brand name combinations (n = 4). Tallman letters were included into the pharmacy dispensing software. Finally, Tallman letters were implemented across the 3 hospitals in the network, i.e. 7 dispensaries and 40 ward medication storage areas.ConclusionTallman letters were successfully introduced and implemented into a hospital network. This was achieved with the expenditure of minimal resources and has improved safety by minimising the risk of selecting the wrong medication.