Corbin Morgan, Bossaer John B
University Health, Shreveport, LA, USA.
East Tennessee State University, Johnson City, TN, USA.
Hosp Pharm. 2017 May;52(5):353-356. doi: 10.1177/0018578717715356. Epub 2017 May 1.
Mannitol has been used in the past for the prevention of cisplatin-induced nephrotoxicity. Studies on its efficacy have conflicting results. An educational newsletter was designed for local oncologists on the conflicting data of mannitol use in preventing cisplatin-induced nephrotoxicity. The purpose of this study was to determine whether a pharmacist-created newsletter intervention led to changes in the mannitol prescribing practices of local oncologists. A newsletter describing the paucity of evidence to support mannitol use to prevent cisplatin-induced nephrotoxicity was distributed via e-mail to local oncologists in October 2010. Mannitol prescribing rates were retrospectively evaluated before and after newsletter distribution. The Mann-Whitney test was used to compare nonparametric continuous data. The chi-square test was used for nominal data. Descriptive statistics were performed for baseline demographics, and odds ratios were calculated for possible risk factors for acute kidney injury (AKI). The primary endpoint was a change in mean mannitol dose before and after the newsletter intervention. The secondary endpoint was the difference in the rate of AKI before and after the intervention. Data were collected for 67 patients with various malignancies. There was a difference in the average mannitol dose before and after newsletter intervention ( = .02). The rates of AKI before and after newsletter were similar. A pharmacist-led newsletter intervention was associated with significantly decreased rates of mannitol usage after intervention.
过去曾使用甘露醇预防顺铂诱导的肾毒性。关于其疗效的研究结果相互矛盾。针对当地肿瘤学家设计了一份教育通讯,内容是关于使用甘露醇预防顺铂诱导的肾毒性的相互矛盾的数据。本研究的目的是确定由药剂师制作的通讯干预措施是否会导致当地肿瘤学家在甘露醇处方实践方面发生变化。2010年10月,一份描述支持使用甘露醇预防顺铂诱导的肾毒性的证据不足的通讯通过电子邮件分发给当地肿瘤学家。在通讯分发前后对甘露醇处方率进行回顾性评估。采用曼-惠特尼检验比较非参数连续数据。卡方检验用于名义数据。对基线人口统计学进行描述性统计,并计算急性肾损伤(AKI)可能危险因素的比值比。主要终点是通讯干预前后甘露醇平均剂量的变化。次要终点是干预前后AKI发生率的差异。收集了67例患有各种恶性肿瘤患者的数据。通讯干预前后甘露醇平均剂量存在差异(P = 0.02)。通讯前后AKI发生率相似。药剂师主导的通讯干预与干预后甘露醇使用率显著降低相关。