Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
J Clin Pharmacol. 2011 Jul;51(7):1043-50. doi: 10.1177/0091270010378858. Epub 2010 Oct 6.
Drug-drug interactions (DDIs) are drug combinations that result in pharmacological or clinical responses that differ from solitary administration. Previous studies of DDIs have been limited to particular drugs or particular patient populations. The authors performed a retrospective cohort study of all adults admitted to a teaching hospital between 1999 and 2005. All medications administered to patients were identified and compared with a standard reference of important DDIs. The authors measured the potential DDI incidence density as the percentage of time in the hospital during which patients were exposed to at least 1 DDI and used multivariate Poisson regression to determine its determinants. A total of 19.3% of 140 349 hospitalizations had at least 1 potential DDI. The potential DDI incidence density was 18.8%. Factors having the greatest influence on potential DDI incidence density included increased patient age (adjusted rate ratio patient >75 years vs <30 years, 2.25; 95% CI, 2.15-2.35), increased number of drug orders (adjusted rate ratio, 2.27 [2.23-2.30] for logarithm), and patient service (adjusted rate ratio, 1.49 [1.46-1.52] for surgical vs medical service). Potential DDIs were present during one fifth of hospitalization time.
药物-药物相互作用（DDI）是指药物联合使用导致药理或临床反应与单独使用不同的情况。以前的 DDI 研究仅限于特定药物或特定患者人群。作者对 1999 年至 2005 年期间入住教学医院的所有成年人进行了回顾性队列研究。对患者使用的所有药物进行了识别，并与重要 DDI 的标准参考进行了比较。作者以患者在医院期间至少暴露于 1 种 DDI 的时间百分比衡量潜在 DDI 发生率密度，并使用多变量泊松回归来确定其决定因素。共有 140349 例住院中有 19.3%至少存在 1 种潜在的 DDI。潜在 DDI 发生率密度为 18.8%。对潜在 DDI 发生率密度影响最大的因素包括患者年龄增加（调整后患者年龄>75 岁与<30 岁的比值比，2.25；95%置信区间，2.15-2.35）、药物处方数量增加（调整后比值比，2.27[2.23-2.30]，对数）和患者服务（调整后手术与医疗服务的比值比，1.49[1.46-1.52]）。潜在的 DDI 在住院时间的五分之一时间内存在。
