Bonetti P O, Hartmann K, Kuhn M, Reinhart W H, Wieland T
Medizinische Klinik, Rätisches Kantons- und Regionalspital, Chur.
Praxis (Bern 1994). 2000 Jan 27;89(5):182-9.
Up to 6% of all hospitalizations are due to adverse drug reactions and 20% of these are caused by drug-drug interactions. There is only little information on the prescription frequency of drug-combinations with the potential to induce dangerous drug-drug interactions and drugs with the need for special patient instruction (e.g. inhalers). The aim of our study was to investigate the frequency of such drug prescriptions at hospital discharge.
In a retrospective, descriptive study drug prescriptions of 100 patients discharged consecutively from the department of internal medicine of a 300 bed-hospital were analysed. Possible drug-drug interactions were detected using a special computer program. Furthermore, the number of prescriptions warranting patient instruction such as anticoagulants, antidiabetics, hormones, immunosuppressive drugs, chemotherapeutics, antituberculotic and antiepileptic drugs as well as inhalatives and injections was recorded.
The mean age of the 100 patients (61 men, 39 women) was 61.7 years, the mean duration of the hospital stay was 9.2 days. At discharge, patients took an average of 3.5 different drugs. Half of the patients were given drug-combinations with the potential for drug-drug interactions, whereby 5% were at risk for the development of interactions of severe and 42% of intermediate degree. All drug-combinations with potentially severe interactions were prescribed deliberately. 31% of all patients took medications with the need for special education, with inhalatives being the most frequent. The prescription of drugs with potential interactions and the necessity for special patient instruction was more frequent in the elderly.
Drug-combinations with the potential of harmful interactions and drugs with the requirement for special patient instruction are frequently prescribed at hospital discharge. The frequency of prescribing these drugs increases with age. Detection of potentially dangerous drug-drug interactions is simplified by special computer programs. Careful patient instruction about the use of certain drugs is a key issue to improve patient compliance and to guarantee an optimal treatment effect.
所有住院病例中高达6%是由药物不良反应所致，其中20%是由药物相互作用引起的。关于具有引发危险药物相互作用潜力的药物组合以及需要对患者进行特殊指导的药物（如吸入器）的处方频率，相关信息非常少。我们研究的目的是调查出院时此类药物处方的频率。
在一项回顾性描述性研究中，分析了一家拥有300张床位医院的内科连续出院的100例患者的药物处方。使用专门的计算机程序检测可能的药物相互作用。此外，记录了需要对患者进行指导的处方数量，如抗凝剂、抗糖尿病药、激素、免疫抑制药、化疗药、抗结核药和抗癫痫药以及吸入剂和注射剂。
100例患者（61例男性，39例女性）的平均年龄为61.7岁，平均住院时间为9.2天。出院时，患者平均服用3.5种不同药物。一半的患者接受了具有药物相互作用潜力的药物组合治疗，其中5%有发生严重相互作用的风险，42%有发生中度相互作用的风险。所有具有潜在严重相互作用的药物组合都是特意开具的。31%的患者服用了需要特殊教育的药物，其中吸入剂最为常见。具有潜在相互作用的药物处方以及对患者进行特殊指导的必要性在老年人中更为常见。
出院时经常开具具有有害相互作用潜力的药物组合以及需要对患者进行特殊指导的药物。这些药物的处方频率随年龄增加而升高。专门的计算机程序简化了对潜在危险药物相互作用的检测。对患者仔细进行某些药物使用方面的指导是提高患者依从性并确保最佳治疗效果的关键问题。
