de Maat M M R, de Boer A, Koks C H W, Mulder J W, Meenhorst P L, van Gorp E C M, Mairuhu A T A, Huitema A D R, Beijnen J H
Department of Pharmacy and Pharmacology, Slotervaart Hospital, Amsterdam, the Netherlands.
J Clin Pharm Ther. 2004 Apr;29(2):121-30. doi: 10.1111/j.1365-2710.2003.00541.x.
To evaluate the usefulness of intervention in drug interactions of antiretroviral drugs with coadministered agents by a clinical pharmacist in outpatient HIV-treatment.
The study design included two intervention arms (A and B), which were both preceded by a control observation period. In arm A, a complete list of the currently used drugs, extracted from pharmacy records was provided to the treating physician. In arm B the same list was provided but with a notification when a drug interaction was present and an advice how to handle this. The infectious disease specialist obtained the information before the patient's visit to the outpatient clinic (time point 0). Three months prior (time point -3) and 3 months after (time point +3) the intervention, pharmacy records were also screened for drug interactions. The number of drug interactions (total and per patient) was determined at the three different time points (-3, 0, +3). In addition, drug interactions encountered at time points -3 and 0 were checked for their presence at time points 0 and +3, respectively, for both intervention arms.
Arms A and B included 115 and 105 patients, respectively. Patient characteristics of both intervention arms were similar at time point 0. The number of interactions and the number of patients with interactions were similar in both intervention arms at time point 0. There were 42 and 40 potential drug interactions in 30 and 24 patients in arms A and B, respectively. The reduction in the number of interactions per patient over time and after intervention was small but significant, and was equal in both intervention arms. The advice of the clinical pharmacist had thus no additional value.
Both interventions were effective in reducing the number of drug interactions per patient. The advice of a clinical pharmacist was, however, redundant in the studied setting.
评估临床药师对门诊接受抗逆转录病毒治疗的艾滋病患者进行药物相互作用干预的有效性。
研究设计包括两个干预组（A组和B组），两组在干预前均有一个对照观察期。A组中，从药房记录中提取的患者当前用药完整清单被提供给主治医生。B组也提供相同的清单，但当存在药物相互作用时会给出通知，并提供处理建议。传染病专科医生在患者门诊就诊前（时间点0）获取信息。在干预前3个月（时间点-3）和干预后3个月（时间点+3），也对药房记录进行药物相互作用筛查。在三个不同时间点（-3、0、+3）确定药物相互作用的数量（总数及每位患者的数量）。此外，分别检查了两个干预组在时间点-3和0时出现的药物相互作用在时间点0和+3时是否仍然存在。
A组和B组分别纳入115例和105例患者。在时间点0时，两个干预组的患者特征相似。在时间点0时，两个干预组的相互作用数量和有相互作用的患者数量相似。A组和B组分别有30例和24例患者存在42种和40种潜在药物相互作用。随着时间推移及干预后，每位患者的相互作用数量减少幅度虽小但具有统计学意义，且两个干预组减少幅度相同。因此临床药师的建议并无额外价值。
两种干预措施均能有效减少每位患者的药物相互作用数量。然而，在本研究环境中，临床药师的建议是多余的。
