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基于网络的儿科药物信息系统在预防儿童和青少年精神病学中严重药物不良反应的价值。

Value of a web-based pediatric drug information system to prevent serious adverse drug reactions in child and adolescent psychiatry.

机构信息

Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wuerzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany.

Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.

出版信息

J Neural Transm (Vienna). 2023 Jan;130(1):53-63. doi: 10.1007/s00702-022-02563-9. Epub 2022 Nov 2.

Abstract

Psychotropic drugs are frequently prescribed 'off-label' to children and adolescents and carry the risk of serious adverse drug reactions (sADR). We examined the frequency of sADRs of psychotropic drugs in pediatric inpatients and explored their potential preventability through following the recommendations of a web-based pediatric drug information system (PDIS). The potential socio-economic impacts of using this online system is also addressed. Routine clinical data from all inpatients treated in a child and adolescent psychiatry department between January 2017 and December 2018 were retrospectively examined for the occurrence of sADRs as defined by the European Medicines Agency. The preventability of the sADRs was assessed based on the information of the PDIS. Furthermore, the expected prolongation of the hospital stay due to sADRs was calculated as well as the associated treatment costs. The study was supported by the Innovation Fund of the Joint Federal Committee, grant number 01NVF16021. In total, 1036 patients were screened of whom 658 (63.5%) received psychopharmacological treatment. In 53 (8.1%) of these patients 54 sADRs were documented, of which 37 sADRs were identified as potentially preventable through PDIS. Mitigating sADR through PDIS would likely have prevented prolonged hospital stays and conferred considerable savings for health insurance companies. PDIS provides systematic and evidence-based information about pediatric psychopharmacotherapy and helps to prevent prescribing errors. Therefore, PDIS is a useful tool to increase drug therapy safety in child and adolescent psychiatry. Further prospective studies are needed to confirm the results.

摘要

精神药物经常被超适应证用于儿童和青少年,并且存在发生严重药物不良反应(sADR)的风险。我们研究了儿科住院患者中精神药物 sADR 的频率,并通过遵循基于网络的儿科药物信息系统(PDIS)的建议来探索其潜在的可预防程度。还讨论了使用该在线系统的潜在社会经济影响。对 2017 年 1 月至 2018 年 12 月期间在儿童和青少年精神病学部门接受治疗的所有住院患者的常规临床数据进行回顾性研究,以确定 sADR 的发生情况,其定义由欧洲药品管理局制定。根据 PDIS 的信息评估 sADR 的可预防程度。此外,还计算了由于 sADR 导致的住院时间延长以及相关的治疗费用。本研究得到联邦联合委员会创新基金的支持,资助编号为 01NVF16021。总共筛选了 1036 名患者,其中 658 名(63.5%)接受了精神药理学治疗。在这些患者中,有 53 名(8.1%)患者记录了 54 例 sADR,其中 37 例 sADR 通过 PDIS 被确定为潜在可预防。通过 PDIS 减轻 sADR 可能会避免延长住院时间,并为保险公司节省可观的费用。PDIS 提供了关于儿科精神药理学治疗的系统和基于证据的信息,有助于预防处方错误。因此,PDIS 是提高儿童和青少年精神病学药物治疗安全性的有用工具。需要进一步的前瞻性研究来证实这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312d/9813149/85e7239abf24/702_2022_2563_Fig1_HTML.jpg

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