脊髓损伤患者治疗方案中的潜在有害药物-药物相互作用。
Potentially harmful drug-drug interactions in the therapeutic regimens of persons with spinal cord injury.
机构信息
School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Canada.
Faculty of Health Sciences, Queen's University, Kingston, Canada.
出版信息
J Spinal Cord Med. 2024 Sep;47(5):692-700. doi: 10.1080/10790268.2023.2185399. Epub 2023 Mar 27.
OBJECTIVES
Individuals with spinal cord injury deal with multiple health complications that require them to use many medications. The purpose of this paper was to find the most common potentially harmful drug-drug interactions (DDIs) in therapeutic regimens of persons with spinal cord injury, and the risk factors associated with it. We further highlight the relevance of each of the DDIs specific to spinal cord injury population.
DESIGN
Observational design and cross-sectional analysis.
SETTING
Community; Canada.
PARTICIPANTS
Individuals with spinal cord injury ( = 108).
MAIN OUTCOME MEASURES/ANALYSIS: The main outcome was the presence of one or more potential DDIs that can lead to an adverse outcome. All the reported drugs were classified as per the World Health Organization's Anatomical Therapeutic Chemical Classification system. Twenty potential DDIs were selected for the analysis based on the most common medications prescribed to people with spinal cord injury and severity of clinical consequences. The medication lists of study participants were analyzed for selected DDIs.
RESULTS
Among the 20 potential DDIs analyzed in our sample, the top 3 prevalent DDIs were Opioids + Skeletal Muscle Relaxants, Opioids + Gabapentinoids, and Benzodiazepines + ≥ 2 other central nervous system (CNS)-active drugs. Of the total sample of 108 respondents, 31 participants (29%) were identified with having at least one potential DDI. The risk of having a potential DDI was highly associated with polypharmacy, though no associations were found between the presence of a drug interaction and age, sex, level of injury, time since injury, or cause of injury among the study sample.
CONCLUSION
Almost three out of ten individuals with spinal cord injury were at risk of having a potentially harmful drug interaction. Clinical and communication tools are needed that facilitate identification and elimination of harmful drug combinations in the therapeutic regimens of patients with spinal cord injury.
目的
脊髓损伤患者会出现多种健康并发症，需要使用多种药物。本文旨在找出脊髓损伤患者治疗方案中最常见的潜在有害药物-药物相互作用（DDI）及其相关危险因素。我们进一步强调了每种脊髓损伤人群特有的 DDI 的相关性。
设计
观察性设计和横断面分析。
地点
社区；加拿大。
参与者
脊髓损伤患者（ = 108）。
主要结果测量/分析：主要结果是存在一种或多种可能导致不良后果的潜在药物相互作用。所有报告的药物均按照世界卫生组织的解剖治疗化学分类系统进行分类。根据脊髓损伤患者常用的药物和临床后果的严重程度，选择了 20 种潜在的 DDI 进行分析。分析研究参与者的药物清单以确定所选 DDI。
结果
在所分析的 20 种潜在 DDI 中，前 3 种常见的 DDI 是阿片类药物 + 骨骼肌松弛剂、阿片类药物 + 加巴喷丁类药物和苯二氮䓬类药物 + ≥ 2 种其他中枢神经系统（CNS）活性药物。在 108 名受访者的总样本中，有 31 名（29%）参与者至少有一种潜在的 DDI。潜在 DDI 的风险与多种药物治疗高度相关，尽管在研究样本中，药物相互作用的存在与年龄、性别、损伤程度、损伤后时间或损伤原因之间没有关联。
结论
近十分之三的脊髓损伤患者存在发生潜在有害药物相互作用的风险。需要临床和沟通工具来帮助识别和消除脊髓损伤患者治疗方案中有害的药物组合。
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