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测定血液科服务中的药物相关问题:一项前瞻性干预研究。

Determination of drug-related problems in the hematology service: a prospective interventional study.

机构信息

Department of Clinical Pharmacy, Faculty of Pharmacy, Suleyman Demirel University, Isparta, Türkiye.

Department of Hematology, Faculty of Medicine, Suleyman Demirel University, Isparta, Türkiye.

出版信息

BMC Cancer. 2024 May 2;24(1):552. doi: 10.1186/s12885-024-12291-w.

Abstract

BACKGROUND

Patients with hematological malignancies often require multidrug therapy using a variety of antineoplastic agents and supportive care medications. This increases the risk of drug-related problems (DRPs). Determining DRPs in patients hospitalized in hematology services is important for patients to achieve their drug treatment goals and prevent adverse effects. This study aims to identify DRPs by the clinical pharmacist in the multidisciplinary team in patients hospitalized in the hematology service of a university hospital in Turkey.

METHODS

This study was conducted prospectively between December 2022 and May 2023 in the hematology service of Suleyman Demirel University Research and Application Hospital in Isparta, Turkey. DRPs were determined using the Pharmaceutical Care Network Europe (PCNE) 9.1 Turkish version.

RESULTS

This study included 140 patients. Older age, longer hospital stay, presence of acute lymphoblastic leukemia, presence of comorbidities, higher number of medications used, and polypharmacy rate were statistically significantly higher in the DRP group than in the non-DRP group (p < 0.05). According to multivariate logistic regression analysis, the probability of DRP in patients with polypharmacy was statistically significant 7.921 times (95% CI: 3.033-20.689) higher than in patients without polypharmacy (p < 0.001).Every 5-day increase in the length of hospital stay increased the likelihood of DRP at a statistically significant level (OR = 1.476, 95% CI: 1.125-1.938 p = 0.005). In this study, at least one DRP was detected in 69 (49.3%) patients and the total number of DRPs was 152. Possible or actual adverse drug events (96.7%) were the most common DRPs. The most important cause of DRPs was drug choice (94.7%), and the highest frequency within its subcategories was the combination of inappropriate drugs (93.4%).

CONCLUSIONS

This study shows the importance of including a clinical pharmacist in a multidisciplinary team in identifying and preventing DRPs in the hematology service.

摘要

背景

患有血液系统恶性肿瘤的患者通常需要使用多种抗肿瘤药物和支持性治疗药物进行多药治疗。这增加了药物相关问题(DRP)的风险。确定土耳其某大学附属医院血液科住院患者的 DRP 对患者实现药物治疗目标和预防不良反应非常重要。本研究旨在确定土耳其某大学附属医院血液科多学科团队中的临床药师确定的住院患者的 DRP。

方法

本研究于 2022 年 12 月至 2023 年 5 月在土耳其伊斯帕尔塔苏莱曼德米雷尔大学研究与应用医院的血液科进行,前瞻性研究。使用欧洲医药保健网络(PCNE)9.1 土耳其语版确定 DRP。

结果

本研究纳入 140 例患者。DRP 组患者年龄较大、住院时间较长、存在急性淋巴细胞白血病、合并症、使用药物种类较多、同时使用多种药物的比例均高于非 DRP 组(p<0.05)。多变量逻辑回归分析显示,同时使用多种药物的患者发生 DRP 的概率显著增加 7.921 倍(95%CI:3.033-20.689)(p<0.001)。住院时间每增加 5 天,DRP 的发生概率就会显著增加(OR=1.476,95%CI:1.125-1.938,p=0.005)。在本研究中,69 例(49.3%)患者至少存在 1 种 DRP,共发现 152 种 DRP。可能或实际的药物不良反应(96.7%)是最常见的 DRP。DRP 的最重要原因是药物选择(94.7%),其亚类中最常见的是药物选择不当(93.4%)。

结论

本研究表明,在血液科多学科团队中纳入临床药师对于确定和预防 DRP 非常重要。

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