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2019年冠状病毒病大流行期间老年心血管疾病患者的处方与服用的多重用药情况及药物相互作用:观察性横断面分析研究

Prescribed Versus Taken Polypharmacy and Drug-Drug Interactions in Older Cardiovascular Patients during the COVID-19 Pandemic: Observational Cross-Sectional Analytical Study.

作者信息

Anfinogenova Nina D, Novikova Oksana M, Trubacheva Irina A, Efimova Elena V, Chesalov Nazary P, Ussov Wladimir Y, Maksimova Aleksandra S, Shelkovnikova Tatiana A, Ryumshina Nadezhda I, Stepanov Vadim A, Popov Sergey V, Repin Alexey N

机构信息

Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia.

Meshalkin National Medical Research Center, Novosibirsk 630055, Russia.

出版信息

J Clin Med. 2023 Aug 1;12(15):5061. doi: 10.3390/jcm12155061.

Abstract

The study aimed to assess clinical pharmacology patterns of prescribed and taken medications in older cardiovascular patients using electronic health records (EHRs) ( = 704) (2019-2022). Medscape Drug Interaction Checker was used to identify pairwise drug-drug interactions (DDIs). Prevalence rates of DDIs were 73.5% and 68.5% among taken and prescribed drugs, respectively. However, the total number of DDIs was significantly higher among the prescribed medications ( < 0.05). Serious DDIs comprised 16% and 7% of all DDIs among the prescribed and taken medications, respectively ( < 0.05). Median numbers of DDIs between the prescribed vs. taken medications were Me = 2, IQR 0-7 vs. Me = 3, IQR 0-7 per record, respectively. Prevalence of polypharmacy was significantly higher among the prescribed medications compared with that among the taken drugs ( < 0.05). Women were taking significantly more drugs and had higher prevalence of polypharmacy and DDIs ( < 0.05). No sex-related differences were observed in the list of prescribed medications. ICD code U07.1 (COVID-19, virus identified) was associated with the highest median DDI number per record. Further research is warranted to improve EHR structure, implement patient engagement in reporting adverse drug reactions, and provide genetic profiling of patients to avoid potentially serious DDIs.

摘要

该研究旨在利用电子健康记录(EHRs)(n = 704)评估老年心血管疾病患者(2019 - 2022年)所开具和服用药物的临床药理学模式。使用Medscape药物相互作用检查器来识别药物间两两相互作用(DDIs)。服用药物和开具药物中DDIs的发生率分别为73.5%和68.5%。然而,开具药物中的DDIs总数显著更高(P < 0.05)。严重DDIs分别占开具药物和服用药物中所有DDIs的16%和7%(P < 0.05)。开具药物与服用药物之间的DDIs中位数分别为每条记录Me = 2,IQR 0 - 7和Me = 3,IQR 0 - 7。与服用药物相比,开具药物中多重用药的发生率显著更高(P < 0.05)。女性服用的药物显著更多,多重用药和DDIs的发生率更高(P < 0.05)。在开具药物清单中未观察到性别相关差异。ICD代码U07.1(COVID - 19,病毒已识别)与每条记录中最高的DDI中位数相关。有必要进行进一步研究以改善电子健康记录结构,促使患者参与报告药物不良反应,并提供患者的基因谱以避免潜在的严重药物相互作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7a1/10420276/5f449bb9a70f/jcm-12-05061-g001.jpg

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