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編者按:2025年9月17日是第七個“世界患者安全日”。9月14日,由《藥物不良反應雜志》、中國藥理學會藥源性疾病學專業(yè)委員會等多家機構聯(lián)合主辦、首都醫(yī)科大學附屬首都兒童醫(yī)學中心承辦的主題活動于北京順利召開。本屆大會聚焦“兒科患者安全與用藥”,匯聚國內外藥學專家共議患者安全核心議題。會上,英國曼徹斯特大學藥物安全領域知名專家Penny J Lewis博士發(fā)表了題為“安全用藥之路”的演講。在與《藥學瞭望》的特約專訪中,Penny J Lewis博士從系統(tǒng)觀和文化視角深入剖析用藥安全的常見盲點與解決路徑,并就人工智能等技術在用藥安全中的角色與邊界分享了其國際前沿的觀察與思考。
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Penny J Lewis博士
《藥學瞭望》:Lewis博士,您的講座主題是“安全用藥之路”。基于您的國際經(jīng)驗,您認為醫(yī)療系統(tǒng)必須采取哪些至關重要但常被忽視的步驟,才能顯著減少用藥錯誤?
Penny J Lewis博士:在用藥安全領域,我們往往過于迅速地聚焦于個人責任,但實際上更應深入審視圍繞個體的系統(tǒng)與流程。我們需要更多地去思考那些影響安全的文化和規(guī)范因素,關注人們所使用的工具、所處的系統(tǒng)和所遵循的流程。只有從整體上理解藥物是如何被使用的,我們才能有效制定干預措施,支持安全用藥。
從我多年研究中得出的一個重要啟示,是良好溝通的價值。溝通問題往往是用藥安全事件的促成因素,表現(xiàn)為醫(yī)療衛(wèi)生專業(yè)人員之間、醫(yī)患之間以及醫(yī)療機構之間信息共享不暢。我們亟須加強溝通支持,賦能患者,促進其參與安全實踐。這一領域值得投入更多的工作和研究。
此外,應推動醫(yī)療衛(wèi)生專業(yè)人員更緊密地整合與知識共享,以造福患者,并努力提升醫(yī)療系統(tǒng)的協(xié)同性。目前的系統(tǒng)往往較為碎片化,患者成為不同機構間唯一連貫的因素。我們或許可以借助技術,使患者在整個醫(yī)療過程中的體驗更加順暢。
(滑動可看英文全文)
Pharmacy Online:Professor Lewis, your lecture focuses on "The Road Towards Safe Medication Use." Based on your international experience, what are some crucial yet often overlooked steps that healthcare systems must take to significantly reduce medication errors?
Professor Penny J Lewis:In medication safety, we can be very quick to focus on individuals. I believe we need to explore more deeply the systems and processes that surround people when they are trying to use medications safely. We should think more about the cultures and norms that influence safety, the tools people use, and the systems and processes within which they work. Only by understanding how medicines are used in a holistic way can we design interventions that truly support safe medication practices.
From the work I’ve done over the years, one particularly important insight is the value of good communication. Communication is often a contributing factor in medication safety incidents. This can occur due to poor communication between healthcare professionals, between professionals and patients, or between healthcare organizations that fail to share information effectively. Much can be done to improve communication, empower patients to engage in their own safety, and promote greater integration among healthcare professionals to share knowledge for the benefit of patients. We also need to consider how to make our healthcare systems more connected—they are often highly fragmented, and the patient is the only consistent factor across these organizations. With the help of technology, we should strive to make the patient’s journey through the healthcare system smoother and safer.
《藥學瞭望》:技術正在迅速改變醫(yī)療保健。您認為人工智能等新興技術可以在安全用藥方面扮演怎樣的角色?在這個過程中,我們應避免哪些潛在的風險或陷阱?
Penny J Lewis博士:人工智能在用藥安全領域蘊藏著巨大機遇。它可用于更快速、更準確地識別風險,也可用于分析諸如用藥事件報告等數(shù)據(jù)。一旦出現(xiàn)問題,我們通常能夠從事件報告中生成海量數(shù)據(jù),而人工處理這些信息耗時巨大。人工智能有助于更快地理解和整合這些信息,并以更友好的格式呈現(xiàn)。
然而,這些信息始終需要人來解讀。人工智能的效能取決于輸入系統(tǒng)的信息質量。我們需要醫(yī)療衛(wèi)生專業(yè)人員和藥師能夠管理這些信息,并合理判斷下一步的優(yōu)先行動。人工智能的確潛力巨大,但我們不應忽視人與技術的交互方式。因此,人工智能使用的社會技術層面將是未來一個重要的研究方向。
(滑動可看英文全文)
Pharmacy Online:Technology is rapidly transforming healthcare. What role do you think emerging technologies like artificial intelligence can play in medication safety, and what potential risks or pitfalls should we avoid in this process?
Professor Penny J Lewis:I think there are excellent opportunities for AI to contribute to medication safety. It could be used to identify risks more quickly and accurately, and to analyze large datasets such as incident reports. When things go wrong, we often generate huge amounts of data from these reports, which take significant time to process manually. AI could help synthesize this information more efficiently and present it in a user-friendly format.
However, human interpretation remains essential—AI is only as good as the data input into the system. Healthcare professionals and pharmacists must be able to manage, interpret, and prioritize AI-generated insights to determine subsequent actions. While AI holds tremendous potential, we must not overlook the socio-technical aspects of its implementation—how humans and AI interact. This intersection is going to be a major area for future research.
專家簡介
Penny Lewis博士
英國曼徹斯特大學
曼徹斯特大學藥學與視光學系高級臨床講師、曼徹斯特大學醫(yī)療基金會信托的“科研學術首席藥師”。
研究領域
首席主持 NIHR SPCR 課題“協(xié)作與協(xié)調行動促用藥安全(COMS)”,聚焦全科診所與社區(qū)藥房的深度協(xié)作模式。
領銜開發(fā)“藥學照護復雜度篩查工具”,精準匹配住院患者的臨床藥學需求。
聯(lián)合申請“基層醫(yī)療協(xié)作實踐的實例評估”項目,以 NHS 社區(qū)藥師會診服務為范例,解析全科、藥房與患者三方聯(lián)動的真實機制。
曾領銜 General Medical Council 委托項目,就醫(yī)生處方差錯根源以及醫(yī)生處方安全持續(xù)研究與剖析
專業(yè)任職
NHSE/NIHR 博士臨床與執(zhí)業(yè)學者獎學金遴選委員會成員
歐洲藥學照護網(wǎng)絡(PCNE)科學委員會成員
2024 國際社會藥學研討會科學委員會成員
英國皇家藥學會“確保用藥安全”工作組特邀成員
英國藥政總局(GPhC)注冊成員
社會責任與影響
致力于用藥安全與藥學服務優(yōu)化領域,積極搭建平臺,鼓勵臨床藥師及其他醫(yī)護人員投身科研
致力于教育公平,為來自弱勢背景卻潛力出眾的學生打通進入 MPharm 課程的通道
緊密圍繞聯(lián)合國可持續(xù)發(fā)展目標(SDGs)的呼應,尤其為“良好健康與福祉”(SDG 3)、“優(yōu)質教育”(SDG 4)及“減少不平等”(SDG 10)貢獻循證方案與實際行動。
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