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社区药房药物治疗监测服务(PMS)在检测和解决与老年患者可能的诊断错误相关的他汀类药物不良反应中的作用

[Role of the Pharmacotherapeutic Monitoring Service (PMS) of the Community Pharmacy in the detection and resolution of adverse reactions to statins linked to possible diagnostic errors in elderly patients].

作者信息

García Martín Diana Laura

机构信息

Universidad de la Laguna. Programa de Doctorado en Ciencias Médicas y Farmacéuticas, Desarrollo y Calidad de Vida. Grupo de Seguridad del paciente de SEFAC. Farmacia Comunitaria Santa Cruz de Tenerife España.

出版信息

Farm Comunitarios. 2024 Sep 17;16(4):5-14. doi: 10.33620/FC.2173-9218.(2024).21. eCollection 2024 Oct 15.

Abstract

INTRODUCTION

The Medication Review in the Pharmacotherapeutic Follow-up Service (PFS) seems to be an effective method to study long-term drug safety in the outpatient setting. The adverse drug reactions (ADRs) that are not immediately obvious are difficult to identify and sometimes can be confused with a more common condition. Misdiagnosis by not associating the symptoms of AMR to its pharmacological cause causes its masking and hinders its detection.

OBJECTIVE

Detect in the SFT service the diagnostic errors related to the non-detection of adverse reactions to statins.

MATERIAL AND METHODS

The data obtained from the medication review at the Pharmacotherapeutic Follow-up Service (PFS) were pooled for analysis. The patients who received the service were selected with the "DLGM screening" tool, an acronym "Diagnosis load Generated by Medications", that allows us to describe adverse drug reactions (ADRs), when their symptoms are attributed to a pathology, without considering medication as a possible underlying cause.Only the results of patients over 60 years of age, who after a prolonged period of statin use gradually presented musculoskeletal disorders (MSD) and other symptoms theoretically described as possible ADRs, are shown.

RESULTS

In 66 % of the cases, corresponding to 14 patients out of a total of 21 studied, the physician modified the treatment and in 92% of these cases there was improvement and a decrease of the consumption of analgesics drug, anti-inflammatory and other drugs used to treat ADR symptoms.

CONCLUSION

DLGM screening identified hidden AMRs in 62 % of patients.

摘要

引言

药物治疗随访服务(PFS)中的用药审查似乎是研究门诊环境中长期药物安全性的有效方法。那些并非立即显现的药物不良反应(ADR)很难识别,有时还可能与更常见的病症相混淆。由于未将药物不良反应的症状与其药理原因联系起来而导致的误诊,会使其被掩盖并阻碍其被发现。

目的

在药物治疗随访服务中检测与他汀类药物不良反应未被发现相关的诊断错误。

材料与方法

汇总从药物治疗随访服务(PFS)的用药审查中获得的数据进行分析。使用“DLGM筛查”工具选择接受该服务的患者,“DLGM”是“药物引发的诊断负荷”的首字母缩写,当药物不良反应(ADR)的症状归因于某种病症时,该工具可让我们描述这些不良反应,而不将药物视为可能的潜在原因。仅展示60岁以上患者的结果,这些患者在长期使用他汀类药物后逐渐出现肌肉骨骼疾病(MSD)以及其他理论上被描述为可能的药物不良反应的症状。

结果

在66%的病例中,即21例研究患者中的14例,医生调整了治疗方案,其中92%的病例症状有所改善,用于治疗药物不良反应症状的镇痛药、抗炎药及其他药物的使用量减少。

结论

DLGM筛查在62%的患者中识别出了隐藏的药物不良反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f91/11491921/5375e1a41176/FC16-04-03_gf01.jpg

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