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智力残疾成年人中潜在药物-药物相互作用的流行率。

The prevalence of potential drug-drug interactions in adults with intellectual disability.

机构信息

Division of Health Research, Lancaster University, Lancaster, UK.

Health and Community Services, Government of Jersey, Saint Helier, Jersey.

出版信息

J Intellect Disabil Res. 2021 Oct;65(10):930-940. doi: 10.1111/jir.12844. Epub 2021 May 14.

Abstract

BACKGROUND

There is a high use of medications in adults with intellectual disability (ID). One implication of taking multiple medications is the potential for drug-drug interactions (DDIs). However, despite this being well highlighted in the mainstream literature, little is known about the incidence or associations of DDIs in the ID population.

METHODS

This study describes the prevalence, patterns and associations of potential DDIs in a total administrative sample of adults with ID known to services in Jersey. Demographic, health-related and medication data were collected from 217 adults known to ID services. Data were collected using a face-to-face survey. The Anatomical Therapeutic Chemical classification system was used to categorise medications, and Stockley's Drug Interaction Checker was used to classify potential DDIs. Drug-drug pairings were considered to be of clinical significance if they were to be 'avoided, adjusted, monitored or required further information'.

RESULTS

Potential DDIs of clinical significance were common. Exposure to potential DDIs of clinical significance was associated with being female, taking more than five medications (polypharmacy), living in residential care and having more health conditions. A simple regression was used to understand the effect of number of prescribed medications on potential DDIs of clinical significance. Every prescribed drug led to a 0.87 (95% confidence interval: 0.72-1.00) increase in having a potential DDI of clinical significance.

CONCLUSION

Adults with ID who live in residential care, who are female, exposed to polypharmacy and have more health conditions may be more likely to have potential DDIs of clinical significance. Urgent consideration needs to be given to the potential of DDIs in this population given their exposure to high levels of medication.

摘要

背景

智力障碍(ID)成年人的药物使用量很高。服用多种药物的一个影响是可能发生药物-药物相互作用(DDI)。然而,尽管这在主流文献中得到了很好的强调,但对于 ID 人群中 DDI 的发生率或相关性知之甚少。

方法

本研究描述了泽西岛服务机构中已知 ID 成年人的总行政样本中潜在 DDI 的流行率、模式和相关性。从已知 ID 服务的 217 名成年人收集人口统计学、健康相关和药物数据。使用面对面的调查收集数据。采用解剖治疗化学分类系统对药物进行分类,采用 Stockley 的药物相互作用检查器对潜在的 DDI 进行分类。如果药物-药物组合被认为具有“避免、调整、监测或需要进一步信息”的临床意义,则将其视为具有临床意义的 DDI。

结果

具有临床意义的潜在 DDI 很常见。接触具有临床意义的潜在 DDI 与女性、服用超过五种药物(多药治疗)、居住在养老院和患有更多健康状况有关。使用简单回归来了解规定药物数量对具有临床意义的潜在 DDI 的影响。每一种规定的药物都会导致出现具有临床意义的潜在 DDI 的几率增加 0.87(95%置信区间:0.72-1.00)。

结论

居住在养老院、女性、暴露于多药治疗且患有更多健康状况的 ID 成年人可能更有可能出现具有临床意义的潜在 DDI。鉴于他们接触到高水平的药物,需要紧急考虑该人群中 DDI 的潜在风险。

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