Ramsay Nadine A, Kenny Martin W, Davies Graham, Patel Jignesh P
School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, East Sussex, UK.
Br J Haematol. 2005 Sep;130(5):777-80. doi: 10.1111/j.1365-2141.2005.05689.x.
The use of complimentary and alternative medicines (CAM) among the UK population is on the increase. For patients requiring warfarin therapy, it is important to maintain an adequate and safe level of anticoagulation. As some forms of CAM can interact with warfarin, it is imperative that any patient considered for warfarin, is asked about their use of CAM. Our report describes the incidence and type of CAM usage among patients about to start or recently commenced on warfarin therapy attending our outpatient anticoagulant clinic. All patients attending clinic for the first time were seen by a pharmacist. A retrospective analysis of the pharmaceutical care plans for all patients seen during 2003 were analysed regarding the degree of CAM usage. Of 631 care plans reviewed, 170 (26.9%) patients were taking some form of CAM. Ninety-nine (58% of all CAM users) were taking a CAM that could interact with warfarin; the commonest forms were cod-liver oil capsules and garlic capsules. We conclude that many patients new to warfarin therapy were significant users of CAM, many of which had the potential to interact with warfarin. By taking a full drug history, potential CAM/warfarin interactions could be avoided.
在英国人群中，补充和替代医学（CAM）的使用正在增加。对于需要华法林治疗的患者，维持足够且安全的抗凝水平很重要。由于某些形式的补充和替代医学可能与华法林相互作用，因此必须询问任何考虑使用华法林的患者其补充和替代医学的使用情况。我们的报告描述了在我们门诊抗凝诊所即将开始或最近开始接受华法林治疗的患者中补充和替代医学使用的发生率和类型。首次到诊所就诊的所有患者都由药剂师诊治。对2003年期间诊治的所有患者的药学护理计划进行回顾性分析，以了解补充和替代医学的使用程度。在审查的631份护理计划中，170名（26.9%）患者正在使用某种形式的补充和替代医学。99名（占所有补充和替代医学使用者的58%）正在服用可能与华法林相互作用的补充和替代医学；最常见的形式是鱼肝油胶囊和大蒜胶囊。我们得出结论，许多刚开始接受华法林治疗的患者大量使用补充和替代医学，其中许多有与华法林相互作用的可能性。通过全面了解用药史，可以避免补充和替代医学/华法林之间潜在的相互作用。
