Weideman R A, Bernstein I H, McKinney W P
Pharmacy Service, Veterans Affairs Medical Center, Dallas, TX 75216, USA.
Am J Health Syst Pharm. 1999 Aug 1;56(15):1524-9. doi: 10.1093/ajhp/56.15.1524.
The ability of pharmacists to identify potential drug interactions was studied. Simulated medication profiles were created from a list of 16 drugs. Staff pharmacists and soon-to-graduate student pharmacists at a Veterans Affairs medical center each received a set of eight 2-drug profiles, four 4-drug profiles, two 8-drug profiles, and one 16-drug profile. Each set of profiles contained a number of pairs of drugs rated by the Drug Therapy Screening System as producing an interaction of moderate or major importance. The subjects were given one hour to screen the profile for the potentially interacting pairs. The subjects detected only 66% of the interactions in the 2-drug profiles, 34% of the interactions in the 4-drug profiles, 20% of the interactions in the 8-drug profiles, and 17% of the interactions in the 16-drug profile. None of the subjects detected all interactions in the 8- or 16-drug profiles. Both true-positive and false-positive rates of identification decreased significantly as the number of drugs listed on the profile increased. This primarily reflected a reduced tendency to report the presence of drug interactions, but there was additional evidence that the accuracy of identification also declined. The number of years of pharmacy training was the only demographic characteristic highly correlated with accuracy. More years of pharmacy education seemed to improve the ability to detect drug interactions. However, none of the pharmacists or students was able to detect all potentially interacting pairs in a profile containing 8 or 16 drugs. Computerized drug interaction profiles should be used by pharmacists to ensure recognition of all potential drug interactions.
研究了药剂师识别潜在药物相互作用的能力。从16种药物列表中创建模拟用药记录。一家退伍军人事务医疗中心的在职药剂师和即将毕业的学生药剂师每人都收到一组用药记录，包括八组两种药物的记录、四组四种药物的记录、两组八种药物的记录和一组十六种药物的记录。每组记录中都包含一些经药物治疗筛查系统评定为产生中度或重大相互作用的药物对。受试者有一小时时间筛查记录以找出潜在相互作用的药物对。受试者仅检测出两种药物记录中66%的相互作用、四种药物记录中%的相互作用、八种药物记录中20%的相互作用以及十六种药物记录中%的相互作用。没有受试者能检测出八种或十六种药物记录中的所有相互作用。随着记录中列出的药物数量增加，识别的真阳性率和假阳性率均显著下降。这主要反映出报告药物相互作用存在的倾向降低，但还有其他证据表明识别的准确性也有所下降。药学培训年限是与准确性高度相关的唯一人口统计学特征。更多年的药学教育似乎能提高检测药物相互作用的能力。然而，没有药剂师或学生能够检测出包含八种或十六种药物的记录中的所有潜在相互作用药物对。药剂师应使用计算机化的药物相互作用记录以确保识别所有潜在的药物相互作用。
