METHODS: The pharmacist intervention rate and the physician acceptance rate were calculated for DDIs involving rifampicin or the SSRIs fluoxetine, paroxetine, duloxetine and sertraline. The rates were compared with a bilateral χ2 test or Fisher\'s exact test.
RESULTS: Of the 284 DDIs recorded, 38 (13.4%) involved rifampicin and 78 (27.5%) involved SSRIs. The pharmacist intervention rate differed significantly (68.4% for rifampicin vs 48.8% for SSRIs; p=0.045) but the physician acceptance rate did not (84.6% for rifampicin vs 81.6% for SSRIs; p=1). Pharmaceutical interventions for SSRIs were more frequent when the ratio of the area under the drug concentration versus time curve in DDI-Predictor was >2. Pharmacists were more likely to issue a pharmacist intervention for DDIs involving rifampicin because of a high perceived risk of treatment failure and were less likely to issue a pharmacist intervention for DDIs involving an SSRI, except when the suspected interaction was strong.
CONCLUSIONS: DDI checkers can help pharmacists to manage DDIs involving strong interactors. DDIs involving strong inhibitors versus a strong inducer differ with regard to their intervention and acceptance rates, notably due to the estimation of the magnitude of the DDI.
方法:计算涉及利福平或SSRIs氟西汀的DDI的药师干预率和医师接受率,帕罗西汀,度洛西汀和舍曲林.采用双侧χ2检验或Fisher精确检验比较。
结果:在记录的284个DDI中,38例(13.4%)涉及利福平,78例(27.5%)涉及SSRIs。药剂师干预率显着差异(利福平为68.4%,SSRI为48.8%;p=0.045),但医师接受率却没有差异(利福平为84.6%,SSRI为81.6%;p=1)。当DDI-Predictor中药物浓度与时间曲线下面积的比值>2时,SSRIs的药物干预更为频繁。药剂师更有可能发布涉及利福平的DDI的药剂师干预,因为治疗失败的风险很高,并且不太可能发布涉及SSRI的DDI的药剂师干预。除非怀疑的互动很强烈。
结论:DDI检查可以帮助药剂师管理涉及强相互作用者的DDI。涉及强抑制剂的DDI与强诱导剂的DDI在干预和接受率方面有所不同。特别是由于对DDI大小的估计。