目的:药品不良反应(ADR)是一个主要的药品安全问题,也是医院药品信息服务部门经常查询的话题。我们的目标是分析这些关于背景的询问,复杂性,ADR的性质,并涉及药物类,以提高院内药物安全性。
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。
OBJECTIVE: Adverse drug reactions (ADRs) are a major drug safety concern and a frequent topic of enquiries to hospital drug information services. Our goal was to analyse these enquiries regarding background, complexity, nature of ADR, and involved drug classes to improve in-hospital drug safety.
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.