在埃塞俄比亚亚的斯亚贝巴的圣保罗医院千年医药学院，对患有慢性肾病的门诊患者的药物相关问题进行研究。
Medication related problems among ambulatory patients with chronic kidney disease at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
机构信息
Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.
Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
出版信息
PLoS One. 2022 Dec 1;17(12):e0278563. doi: 10.1371/journal.pone.0278563. eCollection 2022.
BACKGROUND
Medication related problem (MRP) is an event occurring, as a result, the medication therapy that actually or potentially interferes with desired health outcomes. Evidences reported that the prevalence of MRPs may result in a high burden of morbidity and decrease patients' quality of life. The problem is more significant among patients with chronic kidney disease (CKD) as a decline in kidney function and increase number of medications required to treat kidney disease and its complications. Thus, this study aimed to assess MRPs and its associated factors among patients with chronic kidney disease.
METHOD
Hospital-based cross-sectional study was conducted among 248 adult ambulatory patients with CKD (stage 1-4) at St. Paul's Hospital Millennium Medical College. Data were collected through patient interview and medical chart review from 1st of June to 30th of August 2019. MRPs were identified based on the standard treatment guidelines. Cipolle MRPs classification was used to classify the MRPs and Micromedex® was used as drug interaction checker. Binary logistic regression was utilized to identify the associated factors and p value <0.05 was considered as statistically significant.
RESULT
A total of 325 MRPs were identified from 204 (82.3%) study participants giving 1.6 MRPs per participant. One MRP was identified among 114 (55.9%) patients while two MRPs were identified among 64 (31.4%). The most common class of MRPs were need additional drugs 114 (35.1%) followed by non-compliance 54 (16.6%), unnecessary drug therapy 46 (14.2%) and dose too low 46 (14.2%). The two most common reasons for non-compliance were unaffordability of drugs 26(48.1%) and the lack of patient understanding about drug taking instruction 10 (18.5%). The study showed that only occupation (AOR = 5.2, 95% CI: 1.292-21.288, P = 0.020) and angiotensin converting enzyme inhibitor use (AOR = 6.6, 95% CI: 2.202-19.634, P = 0.001) had an association with the occurrence of MRPs.
CONCLUSION
The prevalence of MRPs among ambulatory patients with CKD was high and need of additional drug therapy was the commonest MRPs.
背景
药物相关问题（MRP）是一种发生的事件，导致药物治疗实际上或潜在地干扰了预期的健康结果。有证据表明，MRP 的发生率可能导致发病率负担增加，并降低患者的生活质量。在慢性肾脏病（CKD）患者中，这个问题更为严重，因为肾功能下降和需要更多的药物来治疗肾脏疾病及其并发症。因此，本研究旨在评估慢性肾脏病患者中的 MRP 及其相关因素。
方法
在 2019 年 6 月 1 日至 8 月 30 日期间，在 St. Paul's Hospital Millennium Medical College 对 248 名成年门诊 CKD（1-4 期）患者进行了基于医院的横断面研究。通过患者访谈和病历回顾收集数据。根据标准治疗指南确定 MRP。使用 Cipolle MRP 分类对 MRP 进行分类，使用 Micromedex®作为药物相互作用检查器。采用二项逻辑回归分析确定相关因素，p 值<0.05 为统计学显著。
结果
从 204 名（82.3%）研究参与者中确定了 325 个 MRP，每个参与者平均有 1.6 个 MRP。114 名（55.9%）患者中发现 1 个 MRP，64 名（31.4%）患者中发现 2 个 MRP。最常见的 MRP 类别是需要额外的药物 114（35.1%），其次是不遵守医嘱 54（16.6%）、不必要的药物治疗 46（14.2%）和剂量过低 46（14.2%）。不遵守医嘱的两个最常见原因是药物负担不起 26（48.1%）和患者对服药说明理解不足 10（18.5%）。研究表明，只有职业（AOR=5.2，95%CI：1.292-21.288，P=0.020）和血管紧张素转换酶抑制剂的使用（AOR=6.6，95%CI：2.202-19.634，P=0.001）与 MRP 的发生有关。
结论
门诊慢性肾脏病患者中 MRP 的发生率较高，需要额外的药物治疗是最常见的 MRP。
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