Aguado Lorenzo Virginia, Jones Matthew D
Imperial College Healthcare NHS Trust, London, UK.
Pharmacy Department, Guy's & St Thomas' NHS Foundation Trust, London, UK.
BMJ Open. 2025 May 30;15(5):e094211. doi: 10.1136/bmjopen-2024-094211.
To explore intravenous drug compatibility information needs of National Health Service (NHS) Injectable Medicines Guide ('Medusa') users. To develop consensus expert recommendations on the intravenous drug compatibility information that Medusa should include.
A convergent parallel design. An online survey of Medusa users. A three-round Delphi project developed expert consensus.
Community, secondary, tertiary and mental healthcare sites across the UK.
142 Medusa users completed the online survey (114 nurses, 28 pharmacists). A panel of 16 nurses and 25 pharmacists currently practising in the NHS with professional expertise relevant to the compatibility of injectable medicines participated in the Delphi project.
Users' ratings of the importance of different types of compatibility information. Consensus expert agreement on a six-point scale regarding the compatibility information that should be provided by Medusa.
97 (68%, 95% CI 60 to 75%) users were involved in the co-infusion of drugs at least weekly. Most users reported co-infusing intravenous fluids (n=116, 82%, 95% CI 75 to 87%), antibiotics (n=85, 60%, 95% CI 52 to 68%) and analgesics (n=81, 57%, 95% CI 49 to 65%) in the past year. They considered information on whether drugs are compatible/incompatible, and the concentrations and diluents in which this occurs, most important (Friedman test p<0.001, Dunn-Bonferroni pairwise comparisons p≤0.028). The expert panel also identified these topics as important for all infused drugs, along with information on time frames, supporting data and specific requirements for the intravenous line (median agreement rating of both professions ≥5 with IQR ≤1.75 in each case).
The co-infusion of drugs is common, so supporting information continues to be important. The most relevant information is that identified by both users and the expert panel: whether drugs are compatible/incompatible, and the concentrations and diluents in which this occurs. The expert panel's recommendation to provide information for all infused drugs contrasts with current more limited national recommendations.
探讨英国国家医疗服务体系（NHS）注射用药品指南（“美杜莎”）用户对静脉药物配伍信息的需求。就“美杜莎”应包含的静脉药物配伍信息制定专家共识推荐意见。
采用聚合平行设计。对“美杜莎”用户进行在线调查。开展三轮德尔菲项目以达成专家共识。
英国各地的社区、二级、三级及精神卫生保健机构。
142名“美杜莎”用户完成了在线调查（114名护士，28名药剂师）。一个由16名护士和25名药剂师组成的专家小组参与了德尔菲项目，这些人员目前在NHS执业，具备与注射用药品配伍相关的专业知识。
用户对不同类型配伍信息重要性的评分。专家小组就“美杜莎”应提供的配伍信息达成六点量表的共识。
97名（68%，95%可信区间60%至75%）用户至少每周参与一次药物联合输注。大多数用户报告在过去一年中联合输注过静脉输液（n = 116，82%，95%可信区间75%至87%）、抗生素（n = 85，60%，95%可信区间52%至68%）和镇痛药（n = 81，57%，95%可信区间49%至65%）。他们认为关于药物是否相容/不相容以及发生这种情况时的浓度和稀释剂的信息最为重要（弗里德曼检验p < 0.001，邓恩 - 邦费罗尼两两比较p≤0.028）。专家小组也确定这些主题对所有输注药物都很重要，同时还包括关于时间框架、支持数据以及静脉输液管的具体要求的信息（两个专业的中位共识评分均≥5，四分位间距在每种情况下≤1.75）。
药物联合输注很常见，因此支持性信息仍然很重要。最相关的信息是用户和专家小组都确定的：药物是否相容/不相容以及发生这种情况时的浓度和稀释剂。专家小组关于为所有输注药物提供信息的建议与目前更有限的国家建议形成对比。
