Amsterdam UMC (location AMC), Department of Medical Informatics, Amsterdam, The Netherlands.
Amsterdam UMC (location AMC), Department of Intensive Care Medicine, Amsterdam, The Netherlands.
J Clin Pharmacol. 2022 Jun;62(6):706-720. doi: 10.1002/jcph.2020. Epub 2022 Feb 21.
Patients admitted to the intensive care unit (ICU) are frequently exposed to potential drug-drug interactions (pDDIs). However, reported frequencies of pDDIs in the ICU vary widely between studies. This can be partly explained by significant variation in their methodological approach. Insight into methodological choices affecting pDDI frequency would allow for improved comparison and synthesis of reported pDDI frequencies. This study aimed to evaluate the association between methodological choices and pDDI frequency and formulate reporting recommendations for pDDI frequency studies in the ICU. The MEDLINE database was searched to identify papers reporting pDDI frequency in ICU patients. For each paper, the pDDI frequency and methodological choices such as pDDI definition and pDDI knowledge base were extracted, and the risk of bias was assessed. Each paper was categorized as reporting a low, medium, or high pDDI frequency. We sought associations between methodological choices and pDDI frequency group. Based on this comparison, reporting recommendations were formulated. Analysis of methodological choices showed significant heterogeneity between studies, and 65% of the studies had a medium to high risk of bias. High risk of bias, small sample size, and use of drug prescriptions instead of administrations were related to a higher pDDI frequency. The findings of this review may support researchers in designing a reliable methodology assessing pDDI frequency in ICU patients. The reporting recommendations may contribute to standardization, comparison, and synthesis of pDDI frequency studies, ultimately improving knowledge about pDDIs in and outside the ICU setting.
患者入住重症监护病房 (ICU) 时常会接触到潜在的药物-药物相互作用 (pDDI)。然而，不同研究中 ICU 中 pDDI 的报告频率差异很大。这在一定程度上可以解释为其方法学方法存在显著差异。深入了解影响 pDDI 频率的方法学选择，将有助于更好地比较和综合报告的 pDDI 频率。本研究旨在评估方法学选择与 pDDI 频率之间的关系，并为 ICU 中 pDDI 频率研究制定报告建议。检索 MEDLINE 数据库以确定报告 ICU 患者 pDDI 频率的论文。对于每篇论文，提取了 pDDI 频率和方法学选择，如 pDDI 定义和 pDDI 知识库，并评估了偏倚风险。将每篇论文分为报告低、中、高 pDDI 频率的类别。我们研究了方法学选择与 pDDI 频率组之间的关联。基于此比较，制定了报告建议。对方法学选择的分析表明，研究之间存在显著的异质性，65%的研究存在中到高度偏倚风险。高偏倚风险、样本量小以及使用药物处方而非给药与更高的 pDDI 频率相关。本综述的结果可能支持研究人员设计一种可靠的方法来评估 ICU 患者的 pDDI 频率。报告建议可能有助于 pDDI 频率研究的标准化、比较和综合，最终提高对 ICU 内外 pDDI 的认识。
