背景:药物超敏反应(DHRs)是药物不良反应(ADRs),对健康相关生活质量(HRQoL)和心理健康尤其有影响。尽管HRQoL作为重要的患者报告结果的作用已在过去几年中得到认可,对ADR患者的HRQoL和心理健康的研究仍然很少。
目的:本系统评价的目的是评估患病率,严重程度,DHR的HRQoL和心理健康的危险因素,特别关注药物引起的过敏反应。
方法:Medline,Scopus,搜索了美国心理学会的Psycharticles数据库,以确定所有的研究,截至2022年12月31日,包括至少一次DHR发作的受试者以及心理健康和/或生活质量的评估。结果报告为定性和定量分析,在评估偏倚和异质性风险后进行荟萃分析。
结果:共纳入45项观察性研究。总的来说,抑郁症的患病率很高(高达51.4%,OR2.94,95CI:1.42-6.10)和焦虑(高达48%,OR3.92,95CI:1.91-8.05)报告,与健康的受试者相比。HRQoL受到显著影响,特别是在药物引起的过敏反应的情况下(平均评分5.88,95CI:0.77-10.98)。
结论:尽管对该主题的研究很少且异质,审查显示,ADR后HRQoL和心理健康受到显着影响。更好地评估HRQoL和表征患者的精神状态可能会提高治疗策略的疗效,这也应该包括心理支持。
Drug hypersensitivity reactions (DHRs) are adverse drug reactions (ADRs) that are particularly impactful on health-related quality of life (HRQoL) and mental health. Although the role of HRQoL as an important patient-reported outcome has been recognized in past years, HRQoL and mental health in patients with ADRs are still poorly investigated.
To evaluate the prevalence, severity, and risk factors of HRQoL and mental health in DHRs, with a particular focus on drug-induced anaphylaxis.
We searched the MEDLINE, Scopus, and American Psychological Association PsycArticles databases to identify all studies up to December 31, 2022 that included subjects with at least one episode of DHR and assessments of mental health and/or quality of life. Results were reported as qualitative and quantitative analyses, with meta-analyses after assessment for risk of bias and heterogeneity.
A total of 45 observational studies were included. Overall, a high prevalence of depression (up to 51.4%; odd ratio = 2.94; 95% CI, 1.42-6.10) and anxiety (up to 48%; odd ratio = 3.92; 95% CI, 1.91-8.05) were reported compared with healthy subjects. The HRQoL was significantly affected, especially in the case of drug-induced anaphylaxis (mean score, +5.88; 95% CI, 0.77-10.98).
Despite the scarce and heterogeneous studies on this topic, the
review shows that HRQoL and mental health are markedly affected after ADRs. A better assessment of HRQoL and characterization of patients\' mental status may improve the efficacy of therapeutic strategies, which should include psychological support.