Wien Katharina, Reißner Pamela, Hefner Gudrun, Thern Julia, Borgwardt Stefan
Hospital Pharmacy, University Medical Center Schleswig-Holstein, Lübeck, Germany.
Department of Psychiatry and Psychotherapy, Center for Integrative Psychiatry, University Medical Center Schleswig-Holstein, Lübeck, Germany.
Front Psychiatry. 2024 Dec 4;15:1460098. doi: 10.3389/fpsyt.2024.1460098. eCollection 2024.
Most psychiatric inpatients receive psychopharmacological treatment indicated for their mental diseases. The aim of this systematic review is to give clinical pharmacists and physicians a comprehensive summary of common drug-related problems (DRPs) in adult psychiatric inpatients and of potential interventions to solve them in clinical practice.
Six databases and registers were searched for English, German and French articles published between 1999 and 2023 with content regarding the prevalence and/or type or interventions to solve DRPs in adult psychiatric inpatients. Studies were categorized based on types of DRPs and clinical interventions. The prevalence rates of DRPs and subtypes were compared quantitatively and the tested interventions were summarized qualitatively.
A total of 88 articles with an overall sample of over 95.425 adult psychiatric inpatients were included in this review. DRPs were reported with a prevalence range of 0.32 to 9.48 per patient. The most frequently reported DRPs were caused by prescribing errors (1.91 per patient), the most frequent subtype was drug interaction (0.77 per patient). Clinical pharmacists were involved in interventions in 7 of 13 included articles. Interventions consisted of clinical pharmacy services on the ward, educational classes, medication reviews, and the implementation of digital tools such as dispensing cabinets and prescribing tools.
The included studies were heterogeneous. The most frequent DRPs in psychiatry are related to prescribing errors and drug interactions. Clinical pharmacists may support the drug therapy by identifying and effectively solving DRPs in psychiatric inpatients using interdisciplinary approaches.
https://www.crd.york.ac.uk/prospero/, identifier CRD42022354958.
大多数精神科住院患者接受针对其精神疾病的心理药物治疗。本系统评价的目的是为临床药剂师和医生提供一份关于成年精神科住院患者常见药物相关问题（DRP）以及临床实践中解决这些问题的潜在干预措施的全面总结。
检索了六个数据库和登记处，查找1999年至2023年期间发表的英文、德文和法文文章，内容涉及成年精神科住院患者中DRP的患病率和/或类型或解决DRP的干预措施。研究根据DRP类型和临床干预进行分类。对DRP及其亚型的患病率进行定量比较，并对测试的干预措施进行定性总结。
本评价共纳入88篇文章，总体样本超过95425名成年精神科住院患者。报告的DRP患病率为每位患者0.32至9.48。最常报告的DRP是由处方错误引起的（每位患者1.91），最常见的亚型是药物相互作用（每位患者0.77）。在纳入的13篇文章中有7篇涉及临床药剂师参与干预。干预措施包括病房临床药学服务、教育课程、用药审查以及实施如配药柜和处方工具等数字工具。
纳入的研究具有异质性。精神科最常见的DRP与处方错误和药物相互作用有关。临床药剂师可通过跨学科方法识别并有效解决精神科住院患者的DRP来支持药物治疗。
