PDF(Pubmed)
Abstract：
BACKGROUND: Drug-drug interactions (DDIs) increase the incidence of adverse drug reactions (ADRs). In a previous report, we revealed that the incidence of potential DDIs due to the same CYP molecular species in one prescription exceeds 90% among patients taking six or more drugs and that CYP3A4 markedly influences the increase in the number of potential DDIs in clinical practice. However, the factors contributing to an increased number of potential DDIs in prescriptions from multiple clinical departments remain poorly clarified.
METHODS: This observational study was performed at five pharmacies in Okayama Prefecture, Japan. Patients who visited these pharmacies from 11 April 2022 to 24 April 2022 were included, except those who had prescriptions only from a single clinical department. A stratified analysis was performed to determine the incidence of CYP3A4-related potential DDIs according to the number of drugs taken. Additionally, factors associated with an increase in the number of drugs involved in CYP3A4-related potential DDIs were identified using multiple linear regression analysis. In this study, potential DDIs for the prescription data subdivided by clinical department, containing two or more drugs, were used as control data.
RESULTS: Overall, 372 outpatients who received prescriptions from multiple clinical departments were included in the current study. The number of drugs contributing to CYP3A4-related potential DDIs increased with an increase in the number of clinical departments. Notably, in cases taking fewer than six drugs, prescriptions from multiple clinical departments had a higher frequency of CYP3A4-related potential DDIs than those in prescriptions subdivided by clinical department. Multiple regression analysis identified \"Cardiovascular agents\", \"Agents affecting central nervous system\", and \"Urogenital and anal organ agents\" as the top three drug classes that increase CYP3A4-related potential DDIs.
CONCLUSIONS: Collectively, these results highlight the importance of a unified management strategy for prescribed drugs and continuous monitoring of ADRs in outpatients receiving prescriptions from multiple clinical departments even if the number of drugs taken is less than six.
METHODS: This observational study was performed at five pharmacies in Okayama Prefecture, Japan. Patients who visited these pharmacies from 11 April 2022 to 24 April 2022 were included, except those who had prescriptions only from a single clinical department. A stratified analysis was performed to determine the incidence of CYP3A4-related potential DDIs according to the number of drugs taken. Additionally, factors associated with an increase in the number of drugs involved in CYP3A4-related potential DDIs were identified using multiple linear regression analysis. In this study, potential DDIs for the prescription data subdivided by clinical department, containing two or more drugs, were used as control data.
RESULTS: Overall, 372 outpatients who received prescriptions from multiple clinical departments were included in the current study. The number of drugs contributing to CYP3A4-related potential DDIs increased with an increase in the number of clinical departments. Notably, in cases taking fewer than six drugs, prescriptions from multiple clinical departments had a higher frequency of CYP3A4-related potential DDIs than those in prescriptions subdivided by clinical department. Multiple regression analysis identified \"Cardiovascular agents\", \"Agents affecting central nervous system\", and \"Urogenital and anal organ agents\" as the top three drug classes that increase CYP3A4-related potential DDIs.
CONCLUSIONS: Collectively, these results highlight the importance of a unified management strategy for prescribed drugs and continuous monitoring of ADRs in outpatients receiving prescriptions from multiple clinical departments even if the number of drugs taken is less than six.
摘要：
背景：药物-药物相互作用（DDI）增加了药物不良反应（ADR）的发生率。在以前的报告中，我们发现,在服用6种或更多种药物的患者中,一个处方中由相同CYP分子种类引起的潜在DDI的发生率超过90%,并且CYP3A4在临床实践中显著影响潜在DDI数量的增加.然而,导致多个临床科室处方中潜在DDI数量增加的因素仍不清楚.
方法：这项观察性研究在冈山县的五家药店进行，日本。从2022年4月11日至2022年4月24日访问这些药房的患者包括在内，除了那些只有一个临床部门处方的人。根据服用的药物数量进行分层分析以确定CYP3A4相关潜在DDI的发生率。此外,我们使用多元线性回归分析确定了与CYP3A4相关潜在DDI相关的药物数量增加相关的因素.在这项研究中,按临床部门细分的处方数据的潜在DDI，含有两种或两种以上药物，用作控制数据。
结果：总体而言，本研究纳入了372名从多个临床科室接受处方的门诊患者。有助于CYP3A4相关潜在DDI的药物数量随着临床科室数量的增加而增加。值得注意的是,如果服用少于六种药物，与按临床科室细分的处方相比,来自多个临床科室的处方出现CYP3A4相关潜在DDI的频率更高.多元回归分析确定了“心血管药物”，“影响中枢神经系统的特工”，和“泌尿生殖器和肛门器官制剂”是增加CYP3A4相关潜在DDI的三大药物类别。
结论：总的来说，这些结果凸显了在接受多个临床科室处方的门诊患者中,即使服用的药物数量少于6种,也必须对处方药物采取统一的管理策略,并持续监测ADR.
方法：这项观察性研究在冈山县的五家药店进行，日本。从2022年4月11日至2022年4月24日访问这些药房的患者包括在内，除了那些只有一个临床部门处方的人。根据服用的药物数量进行分层分析以确定CYP3A4相关潜在DDI的发生率。此外,我们使用多元线性回归分析确定了与CYP3A4相关潜在DDI相关的药物数量增加相关的因素.在这项研究中,按临床部门细分的处方数据的潜在DDI，含有两种或两种以上药物，用作控制数据。
结果：总体而言，本研究纳入了372名从多个临床科室接受处方的门诊患者。有助于CYP3A4相关潜在DDI的药物数量随着临床科室数量的增加而增加。值得注意的是,如果服用少于六种药物，与按临床科室细分的处方相比,来自多个临床科室的处方出现CYP3A4相关潜在DDI的频率更高.多元回归分析确定了“心血管药物”，“影响中枢神经系统的特工”，和“泌尿生殖器和肛门器官制剂”是增加CYP3A4相关潜在DDI的三大药物类别。
结论：总的来说，这些结果凸显了在接受多个临床科室处方的门诊患者中,即使服用的药物数量少于6种,也必须对处方药物采取统一的管理策略,并持续监测ADR.
