Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.

BACKGROUND: Drug name confusion is a common type of medication error and a persistent threat to patient safety. In the USA, roughly one per thousand prescriptions results in the wrong drug being filled, and most of these errors involve drug names that look or sound alike. Prior to approval, drug names undergo a variety of tests to assess their potential for confusability, but none of these preapproval tests has been shown to predict real-world error rates. OBJECTIVES: We conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. METHODS: Eighty participants, comprising doctors, nurses, pharmacists, technicians and lay people, completed a battery of laboratory tests assessing visual perception, auditory perception and short-term memory of look-alike and sound-alike drug name pairs (eg, hydroxyzine/hydralazine). RESULTS: Laboratory test error rates (and other metrics) significantly predicted real-world error rates obtained from a large, outpatient pharmacy chain, with the best-fitting model accounting for 37% of the variance in real-world error rates. Cross-validation analyses confirmed these results, showing that the laboratory tests also predicted errors from a second pharmacy chain, with 45% of the variance being explained by the laboratory test data. CONCLUSIONS: Across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception. Regulators and drug companies seeking a validated preapproval method for identifying confusing drug names ought to consider using these simple tests. By using a standard battery of memory and perception tests, it should be possible to reduce the number of confusing look-alike and sound-alike drug name pairs that reach the market, which will help protect patients from potentially harmful medication errors.

Verb aspect and problem solving.

Verb aspect conveys the temporal flow of an action, such as whether it is on-going or complete. If language guides how situation models are to be constructed, then verb aspect could influence cognition that would use situation models, as in solving insight problems. In this study, verb aspect within the insight problem was manipulated to determine if the imperfective aspect (was accepting) or perfective aspect (accepted) influenced people's solution rates. Results revealed that solution rates for problems that depended on the way an action was being done within the problem were better when the imperfective aspect was used. For problems that did not focus on the action of the sentence, solution rates were better when the perfective aspect was used. The language used to convey problems can influence the ease which people are able to arrive at a solution.