METHODS: Retrospectively, ADR enquiries to a German university hospital pharmacy drug information 2018-2022 were analysed regarding enquirer (profession, medical specialty) and enquiry details (drugs, suspected ADR/enquiry prior to drug initiation, ADR system organ class, probable cause identified, and enquiry complexity).
RESULTS: Of 543 enquiries, 516 (95%) were asked by physicians, 493 (91%) patient-specific, 390 (71%) on suspected ADRs, and 153 (28%) prior to drug initiation. Enquiries originated frequently from internal medicine (74/13.6%), paediatrics (71/13.1%), neurology (70/12.9%), and haemato-oncology (62/11.4%). Most frequent ADRs were haematologic (94/17%) and hepatic (72/13%). The median number of drugs per enquiry was three (range 0-37), 209 (38%) enquiries referred to one specific drug, 165 (30%) concerned ≥11 drugs. A probable cause for suspected ADRs was identified in 75 (36%) enquiries concerning one drug and 155 (94%) with ≥11 drugs. Most frequent drugs were antineoplastic (54/25.8%), nervous-system-drugs (42/20.1%), and anti-infective (40/19.1%). Most enquiries (342/63%) were complex (multiple/specialist resources).
CONCLUSIONS: Enquiries were usually asked by physicians referring to suspected ADRs in specific clinical situations. A probable cause was identified in many cases pointing to a direct positive impact on patient care. Enquiries prior to drug initiation should be encouraged to increase drug safety. Information on main ADR effects and drug classes helps with targeted counselling.
方法:回顾,对德国一所大学医院2018-2022年药房药物信息的ADR查询进行了关于查询者的分析(职业,医学专业)和查询详情(药物,可疑的ADR/药物开始前的询问,ADR系统器官类,确定可能的原因,和查询复杂性)。
结果:在543个查询中,医生询问了516人(95%),493(91%)患者特异性,390(71%)可疑ADR,药物开始前153(28%)。查询经常来自内科(74/13.6%),儿科(71/13.1%),神经病学(70/12.9%),和血液肿瘤学(62/11.4%)。最常见的ADR是血液学(94/17%)和肝(72/13%)。每次查询的药物数量中位数为3种(范围为0-37种),209次(38%)查询涉及一种特定药物,165(30%)有关≥11种药物。在75例(36%)关于一种药物和155例(94%)≥11种药物的查询中,确定了可疑ADR的可能原因。最常见的药物是抗肿瘤(54/25.8%),神经系统药物(42/20.1%),和抗感染药物(40/19.1%)。大多数查询(342/63%)是复杂的(多个/专家资源)。
结论:询问询问通常由医生参考特定临床情况下的可疑不良反应。在许多情况下,确定了可能的原因,指出对患者护理的直接积极影响。应鼓励在药物开始之前进行查询,以增加药物安全性。有关主要ADR影响和药物类别的信息有助于有针对性的咨询。