墨西哥一家三级护理医院急诊科收治的儿科患者中潜在的药物相互作用及其危险因素。
Potential drug-drug interactions and their risk factors in pediatric patients admitted to the emergency department of a tertiary care hospital in Mexico.
作者信息
Morales-Ríos Olga, Jasso-Gutiérrez Luis, Reyes-López Alfonso, Garduño-Espinosa Juan, Muñoz-Hernández Onofre
机构信息
Departamento de Evaluación y Análisis de Medicamentos, Hospital Infantil de México Federico Gómez, Ciudad de México, México.
Centro de Estudios Económicos y Sociales en Salud, Hospital Infantil de México Federico Gómez, Ciudad de México, México.
出版信息
PLoS One. 2018 Jan 5;13(1):e0190882. doi: 10.1371/journal.pone.0190882. eCollection 2018.
BACKGROUND
Drug-drug interactions (DDIs) detected in a patient may not be clinically apparent (potential DDIs), and when they occur, they produce adverse drug reactions (ADRs), toxicity or loss of treatment efficacy. In pediatrics, there are only few publications assessing potential DDIs and their risk factors. There are no studies in children admitted to emergency departments (ED). The present study estimates the prevalence and describes the characteristics of potential DDIs in patients admitted to an ED from a tertiary care hospital in Mexico; in addition, potential DDI-associated risk factors are investigated.
METHODS
A secondary analysis of data from 915 patients admitted to the ED of the Hospital Infantil de México "Federico Gómez" was conducted. The Medscape Drug Interaction Checker software was used to identify potential DDIs. The results are expressed as number of cases (%), means (95% CI) and medians (25-75th percentiles). Count data regressions for number of total and severity-stratified potential DDIs were performed adjusting for patient characteristics, number of administered drugs, days of stay, presence of ADRs and diagnoses.
RESULTS
The prevalence of potential DDIs was 61%, with a median of 4 (2-8). A proportion of 0.2% of potential DDIs was "Contraindicated", 7.5% were classified as "Serious", 62.8% as "Significant" and 29.5% as "Minor". Female gender, age, days of stay, number of administered drugs and diagnoses of Neoplasms (C00-D48), Congenital malformations (Q00-Q99), Diseases of the Blood, Blood-forming Organs and Immunity (D50-D89) and Diseases of the nervous system (G00-G99) were significantly associated with potential DDIs.
CONCLUSION
The prevalence of potential DDIs in the ED is high, and strategies should therefore be established to monitor patients' safety during their stay, in addition to conducting investigations to estimate the real harm potential DDIs inflict on patients.
背景
在患者中检测到的药物相互作用（DDIs）可能在临床上并不明显（潜在的药物相互作用），而当它们发生时，会产生药物不良反应（ADRs）、毒性或治疗效果丧失。在儿科领域，评估潜在药物相互作用及其危险因素的出版物很少。尚无针对急诊科（ED）收治儿童的相关研究。本研究估计了墨西哥一家三级护理医院急诊科收治患者中潜在药物相互作用的患病率，并描述其特征；此外，还对潜在药物相互作用相关的危险因素进行了调查。
方法
对墨西哥“费德里科·戈麦斯”儿童医院急诊科收治的915例患者的数据进行了二次分析。使用Medscape药物相互作用检查软件识别潜在的药物相互作用。结果以病例数（%）、均值（95%置信区间）和中位数（第25至75百分位数）表示。针对患者特征、用药数量、住院天数、药物不良反应的存在情况和诊断，对潜在药物相互作用总数及按严重程度分层的潜在药物相互作用数量进行计数数据回归分析。
结果
潜在药物相互作用的患病率为61%，中位数为4（2 - 8）。潜在药物相互作用中，0.2%为“禁忌”，7.5%被归类为“严重”，62.8%为“显著”，29.5%为“轻微”。女性、年龄、住院天数、用药数量以及肿瘤（C00 - D48）、先天性畸形（Q00 - Q99）、血液、造血器官及免疫系统疾病（D50 - D89）和神经系统疾病（G00 - G99）的诊断与潜在药物相互作用显著相关。
结论
急诊科潜在药物相互作用的患病率较高，因此除了开展调查以评估潜在药物相互作用对患者造成的实际危害外，还应制定策略以监测患者住院期间的安全。
Zotero 插件