Zarrabi Sogol, Hosseini Elham, Sadeghi Kourosh, Vaezi Mohammad, Shahrami Bita
Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran.
J Oncol Pharm Pract. 2024 Sep 2:10781552241281664. doi: 10.1177/10781552241281664.
Patients with hematologic malignancies often receive multiple medications, leading to potential drug-drug interactions (DDIs). Identifying and managing these DDIs is crucial for ensuring patient safety and effective care. This study aimed to identify and describe DDIs and associated factors in hematologic malignancy patients.
This prospective interventional study was conducted at a referral center and included hospitalized patients with hematologic malignancies who were receiving at least four concurrent medications. A pharmacist initially compiled a comprehensive list of all medications through patient interviews and medication reviews, and subsequently, identified and categorized potential DDIs using the Lexi-interact and Micromedex databases. The clinical pharmacist then evaluated the clinical impact of the identified DDIs in every individual patient and provided appropriate interventions to resolve them.
A total of 200 patients met the inclusion criteria for the study, with 1281 DDIs identified across 337 distinct types. The majority of identified DDIs exhibited major severity (52.1%) and pharmacokinetic mechanisms (50.3%), with an unspecified onset (79.4%) and fair evidence (67%). Of the identified DDIs, 81.1% were considered clinically significant, prompting 1059 pharmacotherapy interventions by the clinical pharmacist. Additionally, a significant relationship was observed between the number of drugs used during hospitalization and the occurrence of DDIs (P < 0.001, r = 0.633).
DDIs are highly prevalent among hospitalized patients with hematologic malignancies, with their occurrence increasing alongside the number of medications administrated. The intervention of a clinical pharmacist is crucial to evaluate the clinical impact of these DDIs and implement effective interventions for their management.
血液系统恶性肿瘤患者常接受多种药物治疗，这可能导致潜在的药物相互作用（DDIs）。识别和管理这些药物相互作用对于确保患者安全和有效治疗至关重要。本研究旨在识别和描述血液系统恶性肿瘤患者中的药物相互作用及其相关因素。
这项前瞻性干预性研究在一家转诊中心进行，纳入了正在接受至少四种同时使用药物的住院血液系统恶性肿瘤患者。一名药剂师最初通过患者访谈和药物审查编制了所有药物的综合清单，随后使用Lexi-interact和Micromedex数据库识别并分类潜在的药物相互作用。然后，临床药剂师评估了每例患者中已识别的药物相互作用的临床影响，并提供了适当的干预措施来解决这些问题。
共有200例患者符合该研究的纳入标准，共识别出337种不同类型的1281例药物相互作用。大多数已识别的药物相互作用表现为严重程度较高（52.1%）和药代动力学机制（50.3%），发作情况未明确（79.4%）且证据充分（67%）。在已识别的药物相互作用中，81.1%被认为具有临床意义，促使临床药剂师进行了1059次药物治疗干预。此外，观察到住院期间使用的药物数量与药物相互作用的发生之间存在显著关系（P < 0.001，r = 0.633）。
药物相互作用在住院血液系统恶性肿瘤患者中非常普遍，其发生率随着所用药物数量的增加而上升。临床药剂师的干预对于评估这些药物相互作用的临床影响并实施有效的管理干预措施至关重要。
