SIR Institute for Pharmacy Practice and Policy, Theda Mansholtstraat 5B, 2331 JE, Leiden, The Netherlands.
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
Drug Saf. 2018 Feb;41(2):179-189. doi: 10.1007/s40264-017-0601-7.
The management of drug-drug interactions (DDIs) is a complex process in which risk-benefit assessments should be combined with the patient's perspective.
The aim of this study was to determine patients' and pharmacists' preferences regarding DDI management.
We conducted a choice-based conjoint survey about a fictitious DDI concerning the combination of a cardiovascular drug and an antibiotic for pneumonia. Patients and pharmacists had to choose 12 times between two management options. The options were described by five attributes, including risk, benefit and practical consequences. Each attribute could have two different levels, which were varied over the choice tasks. Latent class analysis was used to identify potential classes of respondents with distinct patterns of similar preferences.
In total, 298 patients and 178 pharmacists completed the questionnaire. The latent class model for both patients and pharmacists resulted in three classes. For patients, in one class the most importance was attached to avoiding switch of medication (class probability 20%), in a second class to fewer adverse events (41%), and in a third class to blood sampling (39%). For pharmacists, again one class attached the highest importance to avoiding switch of medication (31%). The other classes gave priority to curing pneumonia (31%) and avoiding blood sampling (38%).
The results showed diverging preferences regarding DDI management among both patients and pharmacists. Different groups attached different value to risk and benefit versus practical considerations. Awareness of existing variability in preferences among and between pharmacists and patients is a step towards shared decision making in DDI management.
药物-药物相互作用（DDI）的管理是一个复杂的过程，在这个过程中，风险-效益评估应该结合患者的观点。
本研究旨在确定患者和药剂师对 DDI 管理的偏好。
我们进行了一项基于选择的联合调查，涉及一种心血管药物和一种用于治疗肺炎的抗生素联合使用的虚构 DDI。患者和药剂师必须在两种管理方案之间进行 12 次选择。这些方案通过五个属性进行描述，包括风险、效益和实际后果。每个属性都有两个不同的水平，在选择任务中进行了变化。潜在类别分析用于识别具有相似偏好模式的潜在受访者类别。
共有 298 名患者和 178 名药剂师完成了问卷。患者和药剂师的潜在类别模型均产生了三个类别。对于患者，在一个类别中，最重要的是避免药物更换（类别概率 20%），在第二个类别中，最重要的是减少不良反应（41%），在第三个类别中，最重要的是采血（39%）。对于药剂师，再次有一个类别将最重要的是避免药物更换（31%）。其他类别优先考虑治疗肺炎（31%）和避免采血（38%）。
结果表明，患者和药剂师在 DDI 管理方面存在不同的偏好。不同的群体对风险和效益与实际考虑的重视程度不同。了解药剂师和患者之间存在的偏好差异，是朝着 DDI 管理中的共同决策迈出的一步。
