Division of Gastroenterology, McMaster University Department of Medicine, Hamilton, ON, Canada L8S 4K1; Division of Gastroenterology, University of Calgary Therapeutic Endoscopy Training Program, Calgary, AB, Canada T2N 4Z6.
Division of Gastroenterology, McMaster University Department of Medicine, Hamilton, ON, Canada L8S 4K1.
Can J Gastroenterol Hepatol. 2016;2016:2937678. doi: 10.1155/2016/2937678. Epub 2016 Feb 24.
Background. In 2012, Health Canada released a warning regarding domperidone use, based on associations with life-threatening arrhythmias and death. Objective. This study aimed to compare the appropriateness of domperidone prescribing patterns before the advisory to those afterward. Methods. Two retrospective reviews were conducted for patients prescribed domperidone during quarters in 2005 and 2012. Outcomes included appropriateness of indication, dosing regimens, monitoring of electrolytes, baseline electrocardiogram performance and characteristics, presence of left ventricular dysfunction, and coprescription of QT-prolonging medications. Univariable and multivariable logistic regression analyses were performed. p values < 0.05 were considered significant. Results. 290 and 287 patients were analyzed in 2005 and 2012, respectively. Domperidone initiation in hospital decreased from 2005 to 2012 (71.4% versus 39.4%, p < 0.0001) as did prescriptions for nonapproved indications (84.8% versus 58.2%, p < 0.0001). In-hospital initiation predicted prescription for nonapproved indications (OR = 7.01, 95% CI 4.52-10.87, p < 0.0001). Use of domperidone as the sole GI drug predicted nonapproved indications (OR = 2.51, 95% CI 1.38-4.55, p = 0.002). Conclusions. The advisory was associated with more appropriate domperidone initiation and compliance with recommended dosages. Our study suggests the need for increased awareness of the dosing and monitoring of domperidone to ensure patient safety.
2012 年，加拿大卫生部发布了一项关于多潘立酮使用的警告，原因是其与危及生命的心律失常和死亡有关。目的：本研究旨在比较咨询前后多潘立酮处方模式的适宜性。方法：对 2005 年和 2012 年各季度开处方多潘立酮的患者进行了两次回顾性研究。结果包括适应证的适宜性、剂量方案、电解质监测、基线心电图表现和特征、左心室功能障碍的存在以及与 QT 延长药物的共同处方。进行了单变量和多变量逻辑回归分析。p 值<0.05 被认为具有统计学意义。结果：2005 年和 2012 年分别分析了 290 例和 287 例患者。2012 年，医院起始多潘立酮的比例从 2005 年的 71.4%下降至 39.4%（p<0.0001），非适应证处方的比例也从 84.8%下降至 58.2%（p<0.0001）。医院起始预测非适应证处方（OR=7.01，95%CI 4.52-10.87，p<0.0001）。多潘立酮作为唯一的胃肠道药物预测非适应证（OR=2.51，95%CI 1.38-4.55，p=0.002）。结论：咨询与更适宜的多潘立酮起始和遵循推荐剂量有关。本研究表明，需要提高对多潘立酮剂量和监测的认识，以确保患者安全。
