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[药剂师参与监督超说明书用药系统:法国北部酒精使用障碍中巴氯芬处方的CAMTEA系统实例]

[Involvement of pharmacists in systems for supervising off-label medications: example of the CAMTEA system for the prescription of baclofen in alcohol use disorder in Northern France].

作者信息

Auffret M, Rolland B, Deheul S, Lecomte L, Cottencin O, Bordet R, Gautier S

机构信息

Service de pharmacovigilance, CHU de Lille, 59037 Lille cedex, France.

Service d'addictologie, CHU de Lille, 59037 Lille cedex, France; Laboratoire de pharmacologie médicale, EA 1046, université Lille-Nord-de-France, 59045 Lille cedex, France.

出版信息

Ann Pharm Fr. 2014 Jan;72(1):28-32. doi: 10.1016/j.pharma.2013.09.005. Epub 2013 Oct 25.

Abstract

Off-label prescribing matches the using of medications outside the summary of product characteristics. Adverse drug reactions are often poorly studied in off-label situations, which may expose patients to additional safety risks, and impose taking specific precautions. The current off-label prescribing practice of baclofen for alcohol-dependence in France is a typical illustration of such a situation. CAMTEA is a regional system set up in 2010 in Northern France, which gathers addiction and pharmacovigilance specialists, and aims at strengthening the prescription supervising and the monitoring of some off-label medication used for addictive disorders, especially baclofen. Until now, institution or office-based pharmacists have not been implicated, whereas they engaged their liability when delivering off-labeled treatment and they may highly contribute to the patient monitoring and the spotting of adverse events. We propose hereby possible measures for involving pharmacists into the patient supervising system developed within CAMTEA. In the current French context concerning the off-label use of baclofen, which will be the first off-label prescribing practice to be framed by a new legal disposition called "temporary use recommendation", the key role of pharmacists should be highlighted.

摘要

超说明书用药是指在药品说明书总结范围之外使用药物。在超说明书用药情况下,药物不良反应往往研究不足,这可能使患者面临额外的安全风险,并需要采取特定的预防措施。法国目前使用巴氯芬治疗酒精依赖的超说明书用药做法就是这种情况的典型例子。CAMTEA是2010年在法国北部设立的一个区域系统,它汇聚了成瘾和药物警戒专家,旨在加强对用于成瘾性疾病的某些超说明书用药的处方监管和监测,特别是巴氯芬。到目前为止,机构或门诊药师尚未参与其中,然而他们在提供超说明书治疗时需承担责任,并且在患者监测和不良事件发现方面可能发挥重要作用。我们在此提出一些可能的措施,以使药师参与到CAMTEA内部建立的患者监管系统中。在法国当前关于巴氯芬超说明书使用的背景下,这将是首个由名为“临时使用建议”的新法律规定规范的超说明书用药做法,药师的关键作用应得到凸显。

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