Journal of Pharmaceutical Health Care and Sciences最新文献

{"title":"Correction: The impact of a heart failure management protocol based on a hospital-community pharmacist collaboration.","authors":"Junichi Terashima, Takahiro Kambara, Eisei Hori, Masahiro Fukatsu, Yukina Ichiki, Eri Oki, Risako Koketsu, Rika Taguchi, Suzuka Mii, Ryoka Hiro, Teruhiro Sakaguchi, Hiroyuki Osanai, Tomoya Tachi, Tadashi Suzuki","doi":"10.1186/s40780-025-00433-6","DOIUrl":"10.1186/s40780-025-00433-6","url":null,"abstract":"","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"25"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and clinical characteristics for Stenotrophomonas maltophilia infection in an acute care hospital in Japan: a single-center retrospective study.","authors":"Michiya Tanuma, Takayuki Sakurai, Hidemasa Nakaminami, Masayo Tanaka","doi":"10.1186/s40780-025-00429-2","DOIUrl":"https://doi.org/10.1186/s40780-025-00429-2","url":null,"abstract":"<p><strong>Background: </strong>Stenotrophomonas maltophilia (S. maltophilia) is a Gram-negative pathogen that causes opportunistic infections. Although the mortality rate among patients with nosocomial infections caused by S. maltophilia is high, the risk factors for infection vary among studies. Moreover, S. maltophilia is highly resistant to several classes of antimicrobial agents. To date, few studies on S. maltophilia have been conducted in Japan, and the details remain unclear. Therefore, the objective of this study was to investigate the risk factors associated with S. maltophilia infection and the antimicrobial susceptibility of S. maltophilia isolates identified in our hospital.</p><p><strong>Methods: </strong>In this study, we investigated the risk factors associated with S. maltophilia infection and clinical characteristics isolated from patients at the NTT Medical Center Tokyo (Tokyo, Japan). We retrospectively examined the S. maltophilia isolates and the corresponding patients between March 2022 and August 2023.</p><p><strong>Results: </strong>Fifty-eight patients with S. maltophilia isolated (median age, 80.5 years; age range, 49-100 years; 70.7% male) were enrolled in this study. Twelve cases (20.7%) were placed in the S. maltophilia infection group and 46 cases were placed in the S. maltophilia colonization group. Central venous (CV) catheterization and higher Sequential Organ Failure Assessment (SOFA) scores were identified as risk factors for S. maltophilia infection. In addition, the 30-day mortality rate was significantly higher, and the survival rate was significantly lower in patients with S. maltophilia infection. The antimicrobial susceptibility rates of S. maltophilia were as follows: 28.6% for ceftazidime, 2.4% for cefozopran, 96.6% for levofloxacin, 100% for minocycline, and 98.3% for trimethoprim-sulfamethoxazole.</p><p><strong>Conclusions: </strong>In actual clinical practice, S. maltophilia was more frequently isolated from sputum. However, most of the cases were colonization, and cases of infection were rare. Early treatment initiation should be considered for S. maltophilia infection in cases where the pathogen is detected from sterile sites, such as blood cultures and pleural fluid or from sputum in cases with a high SOFA score and CV catheter insertion.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"24"},"PeriodicalIF":1.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial therapy using vancomycin and therapeutic drug monitoring (TDM) in patient with bacteremia caused by Arthrobacter woluwensis:a case report.","authors":"Junichiro Date, Takayoshi Takeno, Shiro Watanabe, Akira Oda","doi":"10.1186/s40780-025-00430-9","DOIUrl":"10.1186/s40780-025-00430-9","url":null,"abstract":"<p><strong>Background: </strong>Arthrobacter woluwensis (A.woluwensis) is gram-positive rod that is endemic to natural environments such as soil, but reports of infections caused by this species are limited, and effective treatment methods have not been established.</p><p><strong>Case presentation: </strong>An 89-year-old man was hospitalized for dysmobility due to anorexia and was started on peripheral intravenous nutrition. He had a fever of 39.5 °C, shivering, and hypotension. Gram-positive rods were detected in two sets of blood cultures. The treatment using vancomycin (VCM) was started due to suspicion of catheter-related bloodstream infection. The organism was identified as A.woluwensis by MALDI-TOF MS. The MIC₅₀ for VCM was 2 µg/mL. Treatment was continued with the goal of achieving an area under the concentration-time curve (AUC) of ≥ 400 µg·h/mL, which is an indicator of the efficacy and safety of VCM in treating MRSA infection. The fever resolved after starting treatment, and the patient's condition stabilized. Further blood cultures became negative, a transthoracic echocardiogram confirmed the exclusion of infective endocarditis, and the treatment was completed after 14 days.</p><p><strong>Conclusions: </strong>This is the first case report using VCM for the treatment and therapeutic drug monitoring (TDM) of A. woluwensis bacteremia. Our results will provide useful information for appropriate infection treatment.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"23"},"PeriodicalIF":1.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetic variability and significance of therapeutic drug monitoring for broad-spectrum antimicrobials in critically ill patients.","authors":"Ryota Tanaka","doi":"10.1186/s40780-025-00425-6","DOIUrl":"10.1186/s40780-025-00425-6","url":null,"abstract":"<p><p>Critically ill patients are susceptible to serious infections due to their compromised conditions and extensive use of medical devices, often requiring empiric broad-spectrum antimicrobial therapy. Failure of antimicrobial therapy in this vulnerable population has a direct impact on the patient's survival; hence, selecting the optimal dosage is critical. This population, however, exhibits complex and diverse disease-related physiological changes that can markedly alter antimicrobial disposition. Inflammatory cytokines overexpressed in the systemic inflammatory response syndrome increase vascular permeability, leading to higher volume of distribution for hydrophilic antimicrobials. These cytokines also downregulate metabolic enzyme activities, reducing the clearance of their substrates. Hypoalbuminemia can increase the volume of distribution and clearance of highly protein-bound antimicrobials. Acute kidney injury decreases, while augmented renal clearance increases the clearance of antimicrobials primarily excreted by the kidneys. Furthermore, continuous renal replacement therapy and extracorporeal membrane oxygenation used in critical illness substantially affect antimicrobial pharmacokinetics. The complex interplay of multiple factors observed in critically ill patients poses a significant challenge in predicting the pharmacokinetics of antimicrobials. Therapeutic drug monitoring is the most effective tool to address this issue, and is proactively recommended for vancomycin, teicoplanin, aminoglycosides, voriconazole, β-lactams, and linezolid in critically ill patients. To streamline this process, model-informed precision dosing is expected to promote personalized medicine for this population.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"21"},"PeriodicalIF":1.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of baloxavir marboxil as a prophylactic against influenza among in-patients and analysis of influenza virus mutations in their isolates at a Japanese hospital during the 2023-2024 flu season.","authors":"Akihide Fujii, Tomohiro Oishi, Eisei Kondo, Zyunko Morihara, Yuka Ikeda, Hideyuki Sumida, Youko Ninomiya, Satoe Uesugi, Kimie Okazaki, Daisuke Yoshioka, Miyoko Kobayashi, Hideho Wada","doi":"10.1186/s40780-025-00418-5","DOIUrl":"10.1186/s40780-025-00418-5","url":null,"abstract":"<p><strong>Background: </strong>Baloxavir marboxil (baloxavir) is a new anti-influenza drug that works as a cap-dependent endonuclease inhibitor. It is approved for prophylactic use against influenza in Japan, but there are few reports on this usage in hospitalized in-patients. It reportedly reduces patient susceptibility to influenza through a mechanism involving amino acid substitution.</p><p><strong>Methods: </strong>Between August 2023 and July 2024, we investigated the efficacy of baloxavir as a prophylactic against influenza among in-patients at our hospital who had close contact with patients who were infected with influenza viruses in the same rooms. We also investigated the I38T influenza virus variant to baloxavir through samples taken from patients with the virus at the hospital.</p><p><strong>Results: </strong>We enrolled a total of 45 in-patients who had close contact with other patients who were confirmed to be infected with influenza in the same room. Among 34 of them who were prescribed baloxavir prophylactically, none developed influenza within 5 days from their last contact with infected patients. Conversely, among the other 11 who did not use baloxavir, three became infected with influenza within 5 days following contact with the infected patient (P = 0.012). In 85 samples taken from the patients with influenza, 25 were H1N1 types and 60 were H3N2. We detected the I38T variant of the cap-dependent endonuclease-baloxavir complex structure in two of the H3N2-type samples. Both of these patients had contracted influenza from their children.</p><p><strong>Conclusions: </strong>According to our results, Baloxavir represents an effective prophylactic against influenza for hospitalized in-patients. However, patients with genetic mutations related to decreased susceptibility to influenza, such as I38T variant, should nevertheless exercise higher levels of caution-particularly around children.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"22"},"PeriodicalIF":1.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of isavuconazole on the concentration of tacrolimus in a patient with genotype CYP3A5*1/*3: a case report.","authors":"Hayato Yokota, Yumiko Akamine, Harumi Hatakeyama, Hideaki Kagaya, Sho Sakamoto, Mitsuru Saito, Masahide Takeda, Kazuhiro Sato, Katsutoshi Nakayama, Masafumi Kikuchi","doi":"10.1186/s40780-025-00427-4","DOIUrl":"10.1186/s40780-025-00427-4","url":null,"abstract":"<p><strong>Background: </strong>Azole antifungals are the standard treatment for pulmonary mycosis, which may develop during long-term immunotherapy for kidney transplant. Isavuconazole (ISCZ) is a cytochrome P450 (CYP) 3 A inhibitor that has a risk of interacting with the immunosuppressive drug tacrolimus (TAC). We report a case of simple pulmonary aspergilloma with renal dysfunction due to increased trough levels of TAC after ISCZ coadministration.</p><p><strong>Case presentation: </strong>A male in his 60s was treated with TAC 3.0 mg/day orally to prevent graft rejection after kidney transplantation. He received a loading dose of ISCZ 600 mg/day orally for two days, followed by a maintenance dose of 200 mg/day for simple pulmonary aspergilloma. The TAC trough concentration increased markedly from 2.4 to 9.9 ng/mL on day 6 after coadministration. The creatinine level increased from 0.70 to 1.08 mg/dL, suggesting renal dysfunction due to TAC. Subsequently, the TAC dosage was reduced, leading to a decreased blood TAC concentration and improved renal function. The patient's genotype was CYP3A5*1/*3.</p><p><strong>Conclusions: </strong>In the early stages of ISCZ treatment, the blood TAC concentration is higher, and CYP3A5 polymorphisms may partially explain the extent of this interaction. We recommend more careful monitoring of TAC and serum creatinine levels for approximately one week after ISCZ administration.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"20"},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of a heart failure management protocol based on a hospital-community pharmacist collaboration.","authors":"Junichi Terashima, Takahiro Kambara, Eisei Hori, Masahiro Fukatsu, Yukina Ichiki, Eri Oki, Risako Koketsu, Rika Taguchi, Suzuka Mii, Ryoka Hiro, Teruhiro Sakaguchi, Hiroyuki Osanai, Tomoya Tachi, Tadashi Suzuki","doi":"10.1186/s40780-025-00426-5","DOIUrl":"10.1186/s40780-025-00426-5","url":null,"abstract":"<p><strong>Background: </strong>Heart failure has a high readmission rate, but interventions by multiple professionals are effective. Although there is growing interest in the management of heart failure by community pharmacists in Japan, no effective method has been developed. We created and verified the effectiveness of a novel heart failure management protocol that community pharmacists could utilize.</p><p><strong>Methods: </strong>This study included 68 patients (80.8 ± 11.8 years; male, 60.3%) diagnosed with heart failure who was admitted to our hospital between March 2022 and September 2023. A protocol was developed for the regular follow-up of patients and responses to exacerbations, in collaboration with pharmacists. Patients who were able to receive follow-up from community pharmacists were included in the intervention group, otherwise they were included in the control group. The primary endpoint was readmission, and the secondary endpoint was a composite of readmission, all-cause death, hospitalization, and dialysis due to dehydration or renal dysfunction.</p><p><strong>Results: </strong>The Kaplan-Meier analysis (p = 0.021) and Cox model (hazard ratio: 0.28, 95% confidence interval: 0.09-0.89, p = 0.031) revealed a significantly lower incidence of heart failure readmission within 360 days in the intervention group than in the control group.</p><p><strong>Conclusions: </strong>The implementation of a heart failure management protocol that provides clear guidance on appropriate patient management enabled pharmacists to effectively reduce the likelihood of adverse events, such as heart failure readmission.</p><p><strong>The registration number: </strong>UMIN000046750, registered on February 1, 2022.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"19"},"PeriodicalIF":1.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a population pharmacokinetic model of vancomycin for patients of advanced age.","authors":"Keisuke Takada, Masaru Samura, Yuki Igarashi, Ayako Suzuki, Tomoyuki Ishigo, Satoshi Fujii, Yuta Ibe, Hiroaki Yoshida, Hiroaki Tanaka, Fumiya Ebihara, Takumi Maruyama, Yukihiro Hamada, Toshiaki Komatsu, Atsushi Tomizawa, Akitoshi Takuma, Hiroaki Chiba, Yusuke Yagi, Yoshifumi Nishi, Yuki Enoki, Kazuaki Taguchi, Koji Tanikawa, Hiroyuki Kunishima, Kazuaki Matsumoto","doi":"10.1186/s40780-025-00423-8","DOIUrl":"10.1186/s40780-025-00423-8","url":null,"abstract":"<p><strong>Background: </strong>Population pharmacokinetic (PPK) models of vancomycin (VCM) commonly use creatinine clearance (CLcr) as a covariate for clearance (CL). However, relying on CLcr in patients of advanced age may lead to inaccuracies in estimating VCM clearance. Therefore, this study aimed to develop and validate a new PPK model specifically for patients aged 75 years and older.</p><p><strong>Methods: </strong>PPK analysis was performed based on the blood concentrations of VCM (n = 159 patients). The predictive performance of the developed model was compared with that of previous models using mean absolute error (MAE) and mean squared error (MSE) for another dataset.</p><p><strong>Results: </strong>The PPK analysis optimized a two-compartment model using CLcr and the Alb levels as covariates at the central compartment of VCM clearance. The final model was as follows: CL (L/h) = 1.96 × (CLcr/3.09) ^0.63 × (Serum albumin (Alb) /2.3) ^0.22 × exponential (0.11). Clearance between the central and peripheral compartments (L/h) = 4.86. Central compartment volume of distribution (L) = 31.78. Peripheral compartment volume of distribution (L) = 53.64. The validation study revealed that compared with those of previous models (ranging from 0.67 to 0.79 L/h and from 0.81 to 1.11 (L/h)², respectively), the final model demonstrated the smallest MAE of 0.60 L/h and MSE of 0.65 (L/h)² for patients of advanced age with serum creatinine levels of < 0.6 mg/dL.</p><p><strong>Conclusion: </strong>The PPK model of VCM for patients of advanced age was optimized by adding the Alb levels and CLcr as covariates for CL. The predictive accuracy of the PPK model for patients with an SCr of < 0.6 mg/dL tended to be higher than those of previous models based just on CLcr. Thus, dosage is suggested to be adjusted based on CLcr and Alb levels for patients with an SCr of < 0.6 mg/dL.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"18"},"PeriodicalIF":1.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of chemotherapy-induced nausea and vomiting or anorexia with plasma levels of five gastrointestinal peptides in patients receiving chemotherapy.","authors":"Ryosuke Tatsuta, Ryota Tanaka, Asami Tashibu, Yosuke Suzuki, Kosuke Suzuki, Tomotaka Shibata, Tadasuke Ando, Toshitaka Shin, Yuhki Sato, Hiroki Itoh","doi":"10.1186/s40780-025-00424-7","DOIUrl":"10.1186/s40780-025-00424-7","url":null,"abstract":"<p><strong>Background: </strong>Imbalance between gastrointestinal peptides has been implicated as a cause of chemotherapy-induced nausea and vomiting (CINV) and anorexia in cancer patients. This study comprehensively evaluated the changes in blood levels of five gastrointestinal peptide: substance P, neuropeptide (NPY), motilin, ghrelin and leptin, following chemotherapy, and the relationship between these peptides and CINV or anorexia.</p><p><strong>Methods: </strong>This single-center, prospective, observational study recruited 20 patients with esophageal cancer, urothelial cancer, or testiculoma undergoing cisplatin-based chemotherapy. Plasma levels of five gastrointestinal peptides were measured on days 1 (baseline; before administering chemotherapy), 3, 5 and 8 of the chemotherapy session. Anorexia and CINV were defined as visual analog scale scores 25 mm or higher at least once during the observation period.</p><p><strong>Results: </strong>Plasma NPY and leptin were significantly elevated in the early phase (day 3) of the chemotherapy session, while plasma motilin and substance P were significantly elevated in the late phase (days 5 and 8). Plasma motilin showed significant elevation on days 5 and 8 compared to baseline in CINV group but no significant increase in non-CINV group, and the levels were significantly higher in CINV than in non-CINV group. Plasma leptin peaked significantly on day 3 in both anorexia and non-anorexia groups, and remained significantly higher on day 5 compared to baseline in anorexia group but not in non-anorexia group.</p><p><strong>Conclusion: </strong>CINV is associated with excessive secretion of motilin and anorexia is related to sustained elevation of leptin, suggesting the potential of these peptides as quantitative indicators of CINV and anorexia.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"17"},"PeriodicalIF":1.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of drug patterns and drug-drug-interactions: associations with physical performance in middle-aged military personnel undergoing rehabilitation- a retrospective cohort study.","authors":"Jennifer-Daniele Schmitz, Roman Korte, Andreas Lison, Joachim Gerß, Christoph Schulze","doi":"10.1186/s40780-025-00422-9","DOIUrl":"10.1186/s40780-025-00422-9","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive medication regimens increase the risk of potential drug-drug interactions, adversely affecting health outcomes regardless of age. This risk is particularly pertinent in the context of medical vocational rehabilitation for middle-aged patients, who aim at facilitating rapid reintegration into employment. Identifying and addressing unfavourable drug regimens may substantially contribute to the effectiveness of interdisciplinary therapeutic interventions.</p><p><strong>Methods: </strong>The retrospective cohort study was conducted among middle-aged soldiers diagnosed with post-traumatic stress disorder and at least one physical impairment and long-term medication intake. Patient records were analysed to investigate the nature of the medication such as the number of drugs and distribution according to the anatomical therapeutic code classification and drug-drug interactions in relation to bicycle ergometry performance.</p><p><strong>Results: </strong>A substantial majority (73.2%) of all patients enrolled were prescribed an average of 3.0 (± 2.0) long-term medications per person. All patients received treatments containing ATC N drugs, which exert antidepressant properties. On average, each patient encountered the possible risk of 1.7 (± 1.3) drug interactions. Patients administered at least two ATC N drugs exhibited reduced maximum performance compared to controls. Conversely, patients receiving at least two drugs, wherein only one drug classified as ATC N, did not demonstrate significant performance differences from the control group. Notably, treatments incorporating selective monoamine reuptake inhibitors significantly reduced maximum performance relative to controls. The risk for potential drug-drug interactions, particularly those leading to QT interval prolongation, accounted for 47.5% of interactions involving ATC N drugs. Patients exclusively exposed to potential QT-prolonging interactions exhibited significantly reduced maximum performance compared to controls as well as patients who experienced different potential interactions.</p><p><strong>Conclusion: </strong>Potential drug-drug interactions and disadvantageous drug combinations were prevalent among middle-aged adults with psychiatric disorders and may hinder a positive prognosis for physical fitness. The findings of this study underscore the importance of personalized medication management and continuous monitoring to mitigate negative impacts. Clinicians should diligently review patients' medication records and adjust therapies accordingly to prevent adverse drug reactions. Proactive strategies, such as regular medication reviews and drug-drug interaction screening tools, may be essential for optimizing therapeutic efficacy and maintaining physical performance.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"11 1","pages":"16"},"PeriodicalIF":1.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}