Faculty of Pharmaceutical Sciences, Hokkaido University, Kita 12-jo, Nishi 6-chome, Kita-ku, Sapporo, 060-0812, Japan.
Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
Int J Clin Pharm. 2020 Oct;42(5):1369-1373. doi: 10.1007/s11096-020-01088-z. Epub 2020 Aug 17.
Background The concurrent use of nonsteroidal anti-inflammatory drugs, renin-angiotensin-aldosterone system blockers, and diuretics, known as a "triple-whammy," is related to the occurrence of acute kidney injury. However, there are few reports regarding the prescription pattern of the triple-whammy. Objective To elucidate the patterns of the triple-whammy prescription in Japan. Methods A cross-sectional study was performed using a health-insurance-claims database that included Japanese people under 75 years of age, and enrolled outpatients that were prescribed any nonsteroidal anti-inflammatory drugs, renin-angiotensin-aldosterone system blockers, and diuretics between April 2017 and June 2017. As an outcome, the proportion of triple-whammy prescriptions was evaluated. Among the patients who received triple-whammy prescriptions, we evaluated the prevalence of chronic kidney disease and the proportion of prescriptions provided for these three drugs from different clinical departments and institutions. Results Overall, 730 of 246,721 (0.3%) patients received triple-whammy prescriptions. Among these patients, 13.3% had underlying chronic kidney disease. The proportions of any of the three drug types prescribed by different clinical departments and institutions was 48.2% and 61.8%, respectively. Conclusions We examined the patterns of triple-whammy prescriptions and concluded that pharmacists need to pay attention to triple-whammy prescriptions if the prescriptions are provided by multiple clinical departments or institutions.
同时使用非甾体抗炎药、肾素-血管紧张素-醛固酮系统阻滞剂和利尿剂，即所谓的“三联疗法”，与急性肾损伤的发生有关。然而，关于三联疗法的处方模式的报道很少。目的：阐明日本的三联疗法处方模式。方法：使用健康保险索赔数据库进行横断面研究，该数据库包含年龄在 75 岁以下的日本人，并招募了 2017 年 4 月至 2017 年 6 月期间服用任何非甾体抗炎药、肾素-血管紧张素-醛固酮系统阻滞剂和利尿剂的门诊患者。作为结果，评估了三联疗法处方的比例。在接受三联疗法处方的患者中，我们评估了慢性肾脏病的患病率以及来自不同临床科室和机构的这三种药物的处方比例。结果：总体而言，在 246721 名患者（0.3%）中，有 730 名患者接受了三联疗法处方。在这些患者中，13.3%患有潜在的慢性肾脏病。不同临床科室和机构开具的三种药物类型的比例分别为 48.2%和 61.8%。结论：我们检查了三联疗法处方的模式，并得出结论，如果处方来自多个临床科室或机构，药剂师需要注意三联疗法处方。
