摘要
目的促进临床合理使用伏立康唑。方法制订医院伏立康唑不良潜在药物相互作用(pDDI)药品合用分级目录,临床药师按药理作用归纳伏立康唑pDDI的风险和用药建议,并对临床科室开展伏立康唑pDDI合理用药专项培训;通过前置审方系统对医嘱(处方)实时干预,提供个体化、精细化的用药提示信息。利用美康智慧药学服务平台的PASS处方点评系统选取安徽省胸科医院2021年1月1日至3月31日(干预前)、2023年1月1日至3月31日(干预后)使用伏立康唑的出院患者,分别作为对照组(186例)与干预组(140例),收集患者相关资料,分析伏立康唑不良pDDI和药品不良反应(ADR)发生情况。结果干预组发生伏立康唑不良pDDI 80例(57.14%)、101例次,显著少于对照组的123例(66.13%)、181例次(P<0.05)。与对照组比较,干预组患者伏立康唑合用奥美拉唑、地塞米松、利福平、辛伐他汀不良pDDI发生频次占比均下降。ADR发生方面,干预组为6.43%,低于对照组的10.22%(P>0.05);其中,伏立康唑不良pDDI发生率为88.89%,略低于对照组的89.47%(P>0.05);严重ADR发生率为11.11%,显著低于对照组的52.63%(P<0.05);出现ADR患者2次及以上伏立康唑不良pDDI发生率为44.44%,高于对照组的36.84%(P>0.05)。结论伏立康唑与多种药物存在多种不良pDDI,临床药师开展合理用药培训、处方干预能降低用药风险,保障患者的用药安全。
Objective To promote the rational use of voriconazole in clinical practice.Methods A catalogue for drug combination classification related to adverse potential drug-drug interactions(pDDIs)of voriconazole in the hospital was formulated.Clinical pharmacists summarized the risks and medication recommendations for voriconazole-related pDDIs based on pharmacological effects,carried out special training on rational use of voriconazole in clinical departments and real-time intervention on medical orders(prescriptions)through the pre-review prescription system,and provided individualized and refined medication reminder information.The patients treated with voriconazole discharged from the Anhui Chest Hospital from January 1 to March 31,2021(before intervention)and from January 1 to March 31,2023(after intervention)were selected as the control group(186 cases)and the intervention group(140 cases)respectively by the PASS prescription review system of the PIP Platform.The related information of patients were collected,the incidence of voriconazole-related adverse pDDIs and adverse drug reactions(ADRs)was analyzed.Results There were 80 cases(57.14%)and 101 case times of voriconazole-related pDDIs in the intervention group,which were significantly less than 123 cases(66.13%)and 181 case times in the control group(P<0.05).Compared with that in the control group,the frequency proportion of adverse pDDIs induced by the combination of voriconazole with omeprazole,dexamethasone,rifampicin and simvastatin in the intervention group decreased.The incidence of ADRs was 6.43%in the intervention group,which was lower than 10.22%in the control group(P>0.05);the incidence of voriconazole-related pDDIs was 88.89%,which was slightly lower than 89.47%in the control group(P>0.05);the incidence of severe ADRs was 11.11%,which was significantly lower than 52.63%in the control group(P<0.05);the proportion of patients having voriconazole-related adverse pDDIs(twice or more)and ADRs was 44.44%,which was lower than 36.84%in the control group(P>0.05).Conclusion There are multiple adverse pDDIs between voriconazole and various drugs.Clinical pharmacists′practice in the rational medication training and prescription intervention can decrease the medication risk and ensure the patients′medication safety.
作者
丁海华
陈道俊
王华
张云玲
DING Haihua;CHEN Daojun;WANG Hua;ZHANG Yunling(Department of Pharmacy,Anhui Chest Hospital,Hefei,Anhui,China 230022;School of Medical Technology,Anhui Medical College,Hefei,Anhui,China 230601;Department of Tuberculosis,Anhui Chest Hospital,Hefei,Anhui,China 230022)
出处
《中国药业》
CAS
2024年第8期9-13,共5页
China Pharmaceuticals
基金
安徽省卫生健康科研项目[AHWJ2022b040]。
关键词
伏立康唑
不良潜在药物相互作用
临床药师
处方审核
合理用药
voriconazole
adverse potential drug-drug interaction
clinical pharmacist
prescription review
rational drug use
