波兰儿科肺病科潜在的药物相互作用分析,包括囊性纤维化患者。

Arkadiusz Adamiszak MPharm, Julia Drobińska MPharm, Irena Wojsyk-Banaszak MD, PhD, Edmund Grześkowiak PhD, Agnieszka Bienert PhD
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引用次数: 0

摘要

儿科药物相互作用数据的缺乏是做出适当治疗决定的一个相关问题。我们的研究旨在调查包括囊性纤维化患者在内的儿科肺病科潜在药物相互作用(pDDIs)的发生率和风险因素。我们进行了一项为期 6 个月的前瞻性观察研究,在此期间,临床药剂师使用 Lexicomp 药物相互作用检查器筛查医疗记录,以确定 pDDIs。我们使用斯皮尔曼秩系数、逻辑回归和曼-惠特尼 U 检验来确定相关性、分析 pDDIs 的风险因素,并将囊性纤维化患者与其他患者进行比较。针对 D 和 X pDDIs 类别提出了建议。在 218 名患者中,发现了 428 个 pDDIs,其中 237 个被归类为有临床意义的 pDDIs。近 60% 的患者至少暴露于一种相关的相互作用。pDDIs 的数量与药物数量(rs = 0.53,P < .001)、住院时间(rs = 0.20,P < .01)和标签外药物(rs = 0.25,P < .001)相关。根据多变量分析,至少 6 种用药(OR = 4.15;95% CI = 2.21-7.78)、4 天住院(OR = 6.41;95% CI = 2.29-17.97)和标签外治疗(OR = 3.37;95% CI = 1.69-6.70)是 pDDIs 的风险因素。尽管囊性纤维化患者在服药数量、合并症和标签外用药方面存在明显差异,但他们并没有更容易发生 pDDI。鉴于缺乏有关儿科人群中 pDDIs 的数据,临床医生和临床药剂师之间需要密切合作,以提高药物治疗的安全性和有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Potential drug–drug interactions analysis in Polish pediatric pneumonology units, including cystic fibrosis patients

The lack of data on drug–drug interactions in pediatrics represents a relevant problem in making appropriate therapeutic decisions. Our study aimed to investigate the incidence and risk factors for potential drug–drug interactions (pDDIs) in pediatric pneumonology units, including cystic fibrosis patients. We performed a 6-month prospective observational study during which clinical pharmacists, using the Lexicomp Drug Interactions checker, screened medical records to identify pDDIs. Spearman's rank coefficient, logistic regression, and the Mann–Whitney U test were used to identify correlations, analyze risk factors for pDDIs, and compare cystic fibrosis patients with the rest, respectively. Recommendations were provided for the D and X pDDIs categories. Within the 218 patients, 428 pDDIs were identified, out of which 237 were classified as clinically significant. Almost 60% of patients were exposed to at least one relevant interaction. The number of pDDIs correlated with the number of; drugs (rs = 0.53, P <  .001), hospitalization length (rs = 0.20, P <  .01), and off-label medicines (rs = 0.25, P <  .001). According to the multivariate analysis, at least 6 administered medications (OR = 4.15; 95% CI = 2.21-7.78), 4 days of hospitalization (OR = 6.41; 95% CI = 2.29-17.97), and off-label therapy (OR = 3.37; 95% CI = 1.69-6.70) were the risk factor for pDDIs. Despite significant differences in the number of medications taken, comorbidities, and off-label drugs, cystic fibrosis patients were not more exposed to pDDI. Given the lack of data on pDDIs in the pediatric population, the need for close cooperation between clinicians and clinical pharmacists to improve the safety and efficacy of pharmacotherapy is highlighted.

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