Use of over-the-counter medications and natural products in patients with moderate and severe chronic renal insufficiency
Use of over-the-counter medications and natural products in patients with moderate and severe chronic renal insufficiency
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DOI：
10.1053/j.ajkd.2006.11.023
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发表时间：
2007-02-01
影响因子：
13.2
通讯作者：
Lalonde, Lyne
中科院分区：
文献类型：
--
作者：
Laliberte, Marie-Claude;Normandeau, Michelle;Lalonde, Lyne
背景：慢性肾功能不全患者使用非处方药和天然药物可能与药物相关问题有关。本研究的目的是描述透析前门诊患者使用非处方药的情况，并确定与使用这些产品相关的药物相关问题。方法：在一项为期6个月的随机对照试验中，由社区药剂师在基线时通过电话采访中度（n = 46）和重度（n = 41）慢性肾功能不全患者，记录他们使用非处方药和天然产品的情况。对每种产品的安全性进行评估，并由2名药剂师独立确定与药物有关的问题。结果：总体而言，83%（95%置信区间[Cl]， 72 - 94）的中度慢性肾功能不全患者和68% （95% Cl, 54 - 83）的重度慢性肾功能不全患者报告至少使用一种非处方药。9%的患者报告了非处方药的禁忌症。中度和重度慢性肾功能不全患者分别有22% （95% Cl, 10 ~ 34）和29% （95% Cl, 15 ~ 43）使用天然产物。同样，3%的患者报告使用至少一种禁忌症天然产品。49%的非处方药和19%的天然产品的患者咨询过健康专业人士。总共查明了65个与毒品有关的问题。结论：非处方药和天然产品的使用在慢性肾功能不全患者中非常普遍，并且通常与药物相关问题有关。这些结果强调了社区药剂师密切监测慢性肾功能不全患者使用这些产品的重要性。
Background: Use of over-the-counter medications and natural products may be associated with drug-related problems among patients with chronic renal insufficiency. The aim of this study is to describe the use of nonprescription medications in patients attending a predialysis clinic and identify drug-related problems associated with the use of these products.Methods: In a 6-month cluster randomized controlled trial, patients with moderate (n = 46) and severe (n 41) chronic renal insufficiency were interviewed over the telephone at baseline by a community pharmacist to document their use of over-the-counter medications and natural products. The safety of each product was assessed, and drug-related problems were identified independently by 2 pharmacists.Results: Overall, 83% (95% confidence interval [Cl], 72 to 94) of patients with moderate chronic renal insufficiency and 68% (95% Cl, 54 to 83) with severe chronic renal insufficiency reported using at least 1 over-the-counter medication. Contraindicated over-the-counter medications were reported by 9% of patients. Natural products were used by 22% (95% Cl, 10 to 34) and 29% (95% Cl, 15 to 43) of patients with moderate and severe chronic renal insufficiency, respectively. Similarly, 3% of patients reported using at least 1 contraindicated natural product. Patients had consulted a health professional for 49% of over-the-counter medications and 19% of natural products. Overall, 65 drug-related problems were identified.Conclusion: The use of over-the-counter medications and natural products is highly prevalent in patients with chronic renal insufficiency and often is associated with a drug-related problem. These results emphasize the importance for community pharmacists to closely monitor the use of these products in patients with chronic renal insufficiency.