追踪南非中央慢性病药品调配与分发（CCMDD）项目中的药物不良反应和用药错误。
Tracking adverse drug reactions and medication errors in the Central Chronic Medicine Dispensing and Distribution (CCMDD) programme in South Africa.
作者信息
Otwombe Kennedy, Munsamy Maggie, Dheda Mukesh, Ramdas Nishana, Herbst Corlee, Pillay Merlin, van Tonder Tanya, Serenata Celicia, Lalla-Edward Samanta
机构信息
Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
出版信息
South Afr J HIV Med. 2022 May 19;23(1):1366. doi: 10.4102/sajhivmed.v23i1.1366. eCollection 2022.
BACKGROUND
The South African Central Chronic Medicine Dispensing and Distribution (CCMDD) programme is a National Health Insurance (NHI) initiative that improves access to medicine for patients.
OBJECTIVES
To describe the frequency of adverse drug reactions (ADRs) and medication errors reported in stable patients living with HIV.
METHOD
This descriptive cross-sectional survey was conducted from August 2020 to October 2020, targeting tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD) and tenofovir disoproxil fumarate/emtricitabine/efavirenz (TEE) patients. The distribution of ADRs and medication errors is presented.
RESULTS
Of 9621 patients, 30.8% ( = 2967) were interviewed, 40.2% ( = 1192) on TLD and 59.8% ( = 1775) on TEE regimens. The majority were women (TLD: 55.8%, = 665; TEE: 75.4%, = 1338); 15% (179/1192) reported ADRs on TLD. Medication errors were low on TLD (1.6%, = 19) and TEE (1.2%, = 22). Receipt of incorrect medication (eight each in TLD and TEE) and associated hospitalisations (one vs two, respectively) were low. Common TLD-associated ADRs were weight gain (47.5%, = 85), headaches (44.7%, = 80), insomnia (39.7%, = 71), restlessness (36.9%, = 66), dizziness (29.6%, = 53), brain fog (27.9%, = 50), nervousness (27.4%, = 49), rash on the skin (24.6%, = 44) and poor concentration (21.2%, = 38).
CONCLUSION
About one in seven patients reported ADRs under TLD. Medication errors were low, possibly due to effective quality control measures and stable patients being on the programme. Knowing the frequency of ADRs and medication errors is critical for enhancing the CCMDD programme.
背景
南非中央慢性病药物配给与分发（CCMDD）计划是一项国家医疗保险（NHI）倡议，旨在改善患者获得药物的机会。
目的
描述在接受抗逆转录病毒治疗的稳定HIV患者中报告的药物不良反应（ADR）和用药错误的发生频率。
方法
这项描述性横断面调查于2020年8月至2020年10月进行，目标人群为服用替诺福韦酯/拉米夫定/多替拉韦（TLD）和替诺福韦酯/恩曲他滨/依非韦伦（TEE）的患者。呈现了药物不良反应和用药错误的分布情况。
结果
在9621名患者中，30.8%（n = 2967）接受了访谈，其中40.2%（n = 1192）服用TLD方案，59.8%（n = 1775）服用TEE方案。大多数为女性（TLD组：55.8%，n = 665；TEE组：75.4%，n = 1338）；15%（179/1192）的TLD使用者报告了药物不良反应。TLD组（1.6%，n = 19）和TEE组（1.2%，n = 22）的用药错误发生率较低。收到错误药物（TLD组和TEE组各8例）及相关住院情况（分别为1例和2例）较少。与TLD相关的常见药物不良反应包括体重增加（47.5%，n = 85）、头痛（44.7%，n = 80）、失眠（39.7%，n = 71）、烦躁不安（36.9%，n = 66）、头晕（29.6%，n = 53）、脑雾（27.9%，n = 50）、紧张（27.4%，n = 49）、皮疹（24.6%，n = 44）和注意力不集中（21.2%，n = 38）。
结论
约七分之一的患者报告在TLD治疗下出现药物不良反应。用药错误发生率较低，这可能归因于有效的质量控制措施以及参与该计划的患者病情稳定。了解药物不良反应和用药错误的发生频率对于加强CCMDD计划至关重要。
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