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三级护理医院中慢性肝病患者药物相关问题的评估

Assessment of Drug-related Problems among Patients of Chronic liver Disease in a Tertiary Care Hospital.

作者信息

Twinkle M J S, Karjal Rahifa Ziyad, Anushree A, Kellarai Adhiti, Shaji Bipin, Shetty Shraddha, Ramkumar P, Joel Juno Jerold

机构信息

Nitte (Deemed to be University), NGSM Institute of Pharmaceutical Sciences (NGSMIPS), Department of Pharmacy Practice, Deralakatte, Mangaluru, India.

Nitte (Deemed to be University), KS Hegde Medical Academy (KSHEMA), Department of General Medicine, Deralakatte, Mangaluru, India.

出版信息

Ethiop J Health Sci. 2024 Nov;34(6):459-468. doi: 10.4314/ejhs.v34i6.5.

Abstract

BACKGROUND

Chronic Liver Disease (CLD) is a long-term condition marked by a gradual decline in liver function. Patients with CLD often experience multimorbidity and polypharmacy, which can adversely affect their health outcomes. The objective of the current study is to identify and resolve the drug-related problems associated with chronic liver disease.

METHODS

This prospective observational study involved 150 patients with CLD over a six-month period. Eligible participants included individuals over 18 years old, diagnosed with CLD based on the Child-Pugh score, and currently receiving treatment. Drug-related problems (DRPs) were identified using the Pharmaceutical Care Network Europe (PCNE) classification version 9.1. Data analysis was conducted using Chi-square and Fisher's exact tests with SPSS software version 29.

RESULTS

A total of 212 DRPs were identified and resolved. The most frequent type of DRP was related to treatment efficacy, with 96 instances (45.29%). Within this category, the subcategory 'effect of drug treatment not optimal' was the most common, accounting for 45 patients (21.23%). Drug interactions were identified as the leading cause of DRPs, comprising 65 cases (30.66%). Most issues were addressed at the prescriber level, with 48.11% of interventions accepted by physicians.

CONCLUSION

This study provides valuable insights into identifying and managing DRPs that can negatively impact treatment outcomes in CLD patients. The findings can assist healthcare professionals in prioritizing strategies to enhance clinical results.

摘要

背景

慢性肝病(CLD)是一种以肝功能逐渐衰退为特征的长期病症。CLD患者常伴有多种疾病且需服用多种药物,这可能对其健康结局产生不利影响。本研究的目的是识别并解决与慢性肝病相关的药物问题。

方法

这项前瞻性观察性研究在六个月内纳入了150例CLD患者。符合条件的参与者包括18岁以上、根据Child-Pugh评分诊断为CLD且正在接受治疗的个体。使用欧洲药学保健网络(PCNE)9.1版分类法识别药物相关问题(DRP)。使用SPSS 29软件进行卡方检验和Fisher精确检验进行数据分析。

结果

共识别并解决了212个DRP。最常见的DRP类型与治疗效果相关,有96例(45.29%)。在这一类别中,“药物治疗效果不佳”子类别最为常见,占45例患者(21.23%)。药物相互作用被确定为DRP的主要原因,包括65例(30.66%)。大多数问题在处方医生层面得到解决,48.11%的干预措施被医生接受。

结论

本研究为识别和管理可能对CLD患者治疗结果产生负面影响的DRP提供了有价值的见解。研究结果可帮助医疗保健专业人员确定优先策略以提高临床效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43e5/12110266/4194fce5d33d/EJHS3406-0459Fig1.jpg

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