Developing a list of high-alert medications for patients with chronic diseases

摘要: Abstract Background Patients with chronic diseases often receive multiple medications and are associated increased vulnerability to medication errors. Identifying high-alert for them would help prioritize the interventions greatest impact improving safety. The aim of this study was develop a list patients illnesses (HAMC list) that prove useful Spanish National Health Service strategies on chronicity. Methods RAND/UCLA appropriateness method used. Drug classes/drugs candidates be included HAMC were identified from literature search in MedLine, bulletins issued by patient safety organizations, incidents recorded incident reporting systems, previous lists. Eighteen experts patient/medication or scored candidate drugs according three criteria (evidence, benefit feasibility implementing practices). Additionally they rated their priority inclusion Likert scale. Results final includes 14 drug classes (oral anticoagulants, narrow therapeutic range antiepileptics, antiplatelets – including aspirin –, antipsychotics, β-blockers, benzodiazepines analogues, corticosteroids long-term use, oral cytostatics, hypoglycemic drugs, immunosuppressants, insulins, loop diuretics, nonsteroidal anti-inflammatory opioid analgesics), 4 pairs (amiodarone/ dronedarone, digoxin, methotrexate spironolactone/eplerenone). Conclusions An initial has been developed, which can built into management chronicity guide implementation efficient identify those at greater risk preventable adverse events.