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在尼日利亚中北部的一家 HIV 诊所接受抗逆转录病毒治疗的患者中发现的药物治疗问题:一项前瞻性研究。

Drug therapy problems identified among patients receiving antiretroviral treatment in a HIV clinic: a prospective study in North Central, Nigeria.

机构信息

Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, University of Lagos, Idiaraba, Lagos State, Nigeria.

Pharmaceutical Systems and Policy Department, West Virginia University School of Pharmacy, Morgantown, West Virginia, USA.

出版信息

Pan Afr Med J. 2021 Dec 16;40:233. doi: 10.11604/pamj.2021.40.233.28160. eCollection 2021.

Abstract

INTRODUCTION

despite improved life expectancy for people living with HIV (PLWH), aging, comorbidities, and associated drug treatment increase the risk for drug therapy problems (DTPs). We assessed pharmacists´ identification and resolution of DTPs among PLWH.

METHODS

a prospective study was conducted among PLWH aged ≥10 years (N=100) in a Nigerian HIV clinic. Trained pharmacists delivered a six-step intervention that included the establishment of patient-provider relationship, gathering and validation of patient´s data, identification of DTPs, intervention, outcome identification, and documentation. Descriptive statistics were used to examine data collected via a pharmaceutical care assessment tool.

RESULTS

in all, 215 DTPs were identified and classified as unnecessary drug therapy [27.4% (n=59)], non-adherence [21.9% (n=47)], needs additional drug therapy [16.7% (n=36)], adverse drug reaction [(14.0% (n=30)], wrong drug [(10.7% (n=23)], and dosage variation [n=20 (9.3%)]. Within each DTP class, the most common cause was addiction/recreational drug use [39.0% (n=23)], drug product not available [63.8% (n=30)], untreated condition(s) [61.1% (n=22)], undesirable effects [66.7% (n=20)], condition refractory to drug [34.8% (n=8)], and drug interaction [45.0% (n=9)], respectively. The most common interventions were medication information/recommendation to patients/prescribers (30.4%) and initiation of drug therapy (22.2%). Six-month resolution rate was 90% (n=194) with the most common outcomes being improvement in patient adherence [23.6% (n=50)], addition of a drug [18.9% (n=40)], and reduction in drug overuse [15.6% (n=33)].

CONCLUSION

pharmacists´ intervention resulted in 90% resolution of detected DTPs, implying that pharmacists are crucial in improving antiretroviral treatment outcomes.

摘要

简介

尽管感染艾滋病毒(HIV)的患者(PLWH)的预期寿命有所提高,但老龄化、合并症和相关药物治疗增加了药物治疗问题(DTPs)的风险。我们评估了药师在 PLWH 中发现和解决 DTP 的情况。

方法

在尼日利亚的一家 HIV 诊所中,对年龄≥10 岁的 PLWH(N=100)进行了一项前瞻性研究。经过培训的药师实施了六步干预措施,包括建立医患关系、收集和验证患者数据、识别 DTP、干预、结果识别和记录。使用描述性统计数据来检查通过药物治疗评估工具收集的数据。

结果

共发现 215 个 DTP,分为不必要的药物治疗[27.4%(n=59)]、不依从[21.9%(n=47)]、需要额外的药物治疗[16.7%(n=36)]、药物不良反应[14.0%(n=30)]、用药错误[10.7%(n=23)]和剂量变化[n=20(9.3%)]。在每个 DTP 类别中,最常见的原因是成瘾/滥用药物[39.0%(n=23)]、药物产品不可用[63.8%(n=30)]、未治疗的疾病(s)[61.1%(n=22)]、不良影响[66.7%(n=20)]、疾病对药物难治[34.8%(n=8)]和药物相互作用[45.0%(n=9)]。最常见的干预措施是向患者/处方者提供药物信息/建议(30.4%)和开始药物治疗(22.2%)。六个月的解决率为 90%(n=194),最常见的结果是改善患者的依从性[23.6%(n=50)]、添加药物[18.9%(n=40)]和减少药物滥用[15.6%(n=33)]。

结论

药师的干预措施使 90%的检测到的 DTP 得到解决,这表明药师在改善抗逆转录病毒治疗结果方面至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/983a/8817191/20ad9cf49010/PAMJ-40-233-g001.jpg

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