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重症监护病房中药物相互作用的相关性——重症监护医生和药剂师的看法。

Relevance of drug-drug interaction in the ICU - perceptions of intensivists and pharmacists.

作者信息

Askari Marjan, Eslami Saied, Louws Mathijs, Dongelmans Dave, Wierenga Peter, Kuiper Rob, Abu-Hanna Ameen

机构信息

Dep. of Medical Informatics, Academic Medical Center, Amsterdam, the Netherlands.

出版信息

Stud Health Technol Inform. 2012;180:716-20.

Abstract

Relevancy of potential drug-drug interactions (pDDIs) is crucial in alerting system design. However, the way this relevancy is perceived is not well understood. The main objective of this study was to gauge and identify differences in perceptions of intensivists and pharmacists about pDDI relevancy in the ICU. Interactions were defined according to the national medication database using a computerized algorithm. Intensivists and pharmacists filled in a questionnaire to score their perceptions on relevancy of encountered pDDIs types. We conducted a focus group session to discuss pDDIs receiving markedly different relevancy scores. The questionnaire addressed 53 pDDI types. Pharmacists rated 29 pDDI types (54.7%) in the broad category "relevant" versus 16 (30.2%) for intensivists (p-value<0.001). The pharmacists and intensivists gave the same scores for 23 pDDI types (12 as relevant, and 11 as not relevant), and scored 30 types differently. The focus group discussion resulted in a total of 36 relevant and 17 not relevant types. Compared to the pharmacists in this panel, the intensivists were less inclined to consider a pDDI type as relevant. It is important to tailor medication databases with information about evidence and severity of pDDIs to the environment in which they are used.

摘要

潜在药物相互作用(pDDIs)的相关性在警报系统设计中至关重要。然而,人们对这种相关性的认知方式却尚未得到充分理解。本研究的主要目的是评估并确定重症监护医生和药剂师对重症监护病房(ICU)中pDDIs相关性的认知差异。根据国家药物数据库,使用计算机算法定义相互作用。重症监护医生和药剂师填写一份问卷,以对他们遇到的pDDIs类型的相关性认知进行评分。我们组织了一次焦点小组会议,讨论相关性得分明显不同的pDDIs。问卷涉及53种pDDI类型。药剂师将29种pDDI类型(54.7%)评定为“相关”这一宽泛类别,而重症监护医生评定为16种(30.2%)(p值<0.001)。药剂师和重症监护医生对23种pDDI类型给出了相同的评分(12种评定为相关,11种评定为不相关),对30种类型的评分不同。焦点小组讨论得出共有36种相关类型和17种不相关类型。与该小组中的药剂师相比,重症监护医生不太倾向于将一种pDDI类型视为相关。根据pDDIs的证据和严重程度信息,针对其使用环境定制药物数据库非常重要。

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