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[精神医学中的药物相互作用]

[Drug-drug-interactions in psychiatry].

作者信息

Hahn Martina, Reiff Julia, Hiemke Christoph, Braus Dieter F

机构信息

Klinik und Poliklinik für Psychiatrie und Psychotherapie; HSK, Dr. Horst Schmidt Klinik GmbH, Wiesbaden.

出版信息

Psychiatr Prax. 2013 Apr;40(3):154-8. doi: 10.1055/s-0032-1332831. Epub 2013 Jan 23.

Abstract

OBJECTIVE

In daily practice of psycho-pharmacotherapy most patients are under polypharmacy which may result in potentially harmful drug-drug interactions. Therefore, we investigated if the risk of drug-drug interactions can be reduced by a consultant clinical pharmacist for the physicians on psychiatric wards.

METHODS

Drug-drug-interactions and adverse drug reactions of patients on 2 psychiatric intensive care units were investigated retrospectively in 2008 and 2009. Before the second investigation period, a special training was performed and during this period a pharmacist supported the physicians regarding drug therapy.

RESULTS

After the introduction of a pharmacist on the ward and 2 teaching lessons relevant drug interactions were reduced by 78 % (p < 0.001), the number of all interactions by 44 % (p < 0.001). The total number of drug interactions decreased by the training sessions, which were offered shortly before starting the second observation period, from 3.4 interactions/patients in 2008 to 2.2 interactions/patients in 2009 (p < 0.04).

CONCLUSION

A clinical pharmacist on the ward can contribute to a higher drug therapy safety in psychiatric wards. An interdisciplinary approach can relieve the physicians' daily work. The drug therapy can be improved by continuous teaching sessions about drug interactions.

摘要

目的

在精神药物治疗的日常实践中,大多数患者接受多种药物联合治疗,这可能导致潜在有害的药物相互作用。因此,我们调查了精神科病房的临床药师顾问能否为医生降低药物相互作用的风险。

方法

回顾性调查了2008年和2009年两个精神科重症监护病房患者的药物相互作用和药物不良反应。在第二个调查期之前,进行了一次专门培训,在此期间,一名药师在药物治疗方面为医生提供支持。

结果

在病房配备药师并开展两堂相关教学课后,相关药物相互作用减少了78%(p<0.001),所有相互作用的数量减少了44%(p<0.001)。在第二个观察期开始前不久提供的培训课程使药物相互作用的总数从2008年的3.4次/患者降至2009年的2.2次/患者(p<0.04)。

结论

病房临床药师有助于提高精神科病房的药物治疗安全性。跨学科方法可以减轻医生的日常工作负担。通过持续开展关于药物相互作用的教学课程可以改善药物治疗。

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