Wotring Virginia E, Smith LaRona K
Aerosp Med Hum Perform. 2020 Jan 1;91(1):41-45. doi: 10.3357/AMHP.5392.2020.
There are knowledge gaps in spaceflight pharmacology with insufficient in-flight data to inform future planning. This effort directly addressed in-mission medication use and also informed open questions regarding spaceflight-associated changes in pharmacokinetics (PK) and/or pharmacodynamics (PD). An iOS application was designed to collect medication use information relevant for research from volunteer astronaut crewmembers: medication name, dose, dosing frequency, indication, perceived efficacy, and side effects. Leveraging the limited medication choices aboard allowed a streamlined questionnaire. There were 24 subjects approved for participation. Six crewmembers completed flight data collection and five completed ground data collection before NASA's early study discontinuation. There were 5766 medication use entries, averaging 20.6 ± 8.4 entries per subject per flight week. Types of medications and their indications were similar to previous reports, with sleep disturbances and muscle/joint pain as primary drivers. Two subjects treated prolonged skin problems. Subjects also used the application in unanticipated ways: to note drug tolerance testing or medication holiday per research protocols, and to share data with flight surgeons. Subjects also provided usability feedback on application design and implementation. The volume of data collected (20.6 ± 8.4 entries per subject per flight week) is much greater than was collected previously (<12 per person per entire mission), despite user criticisms regarding app usability. It seems likely that improvements in a software-based questionnaire application could result in a robust data collection tool that astronauts find more acceptable, while simultaneously providing researchers and clinicians with useful data.
航天药理学存在知识空白,飞行中的数据不足,无法为未来规划提供信息。这项工作直接涉及任务中的药物使用情况,也为有关航天相关的药代动力学(PK)和/或药效学(PD)变化的未决问题提供了信息。设计了一个iOS应用程序,用于从志愿宇航员机组人员那里收集与研究相关的药物使用信息:药物名称、剂量、给药频率、适应症、感知疗效和副作用。利用飞船上有限的药物选择,设计了一份精简问卷。有24名受试者被批准参与。在NASA提前终止早期研究之前,6名机组人员完成了飞行数据收集,5名完成了地面数据收集。共有5766条药物使用记录,平均每位受试者每周飞行中有20.6±8.4条记录。药物类型及其适应症与之前的报告相似,睡眠障碍和肌肉/关节疼痛是主要原因。两名受试者治疗了长期的皮肤问题。受试者还以意想不到的方式使用该应用程序:根据研究方案记录药物耐受性测试或药物假期,并与飞行外科医生共享数据。受试者还对应用程序的设计和实施提供了可用性反馈。尽管用户对应用程序的可用性提出了批评,但收集到的数据量(每位受试者每周飞行20.6±8.4条记录)比之前收集的要多得多(整个任务每人<12条)。基于软件的问卷应用程序的改进似乎可能会产生一个强大的数据收集工具,宇航员会觉得更易于接受,同时为研究人员和临床医生提供有用的数据。