Identification of serious drug-drug interactions: results of the partnership to prevent drug-drug interactions.
Identification of serious drug-drug interactions: results of the partnership to prevent drug-drug interactions.
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DOI：
10.1331/154434504773062591
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发表时间：
2004-03-01
期刊：
影响因子：
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通讯作者：
Lipton, Richard B
中科院分区：
文献类型：
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作者：
Malone, Daniel C;Abarca, Jacob;Lipton, Richard B
目的：开发一份可能在社区和门诊药房环境中遇到并由计算机化药房系统检测到的临床重要药物相互作用(DDIS)的清单。设计：横断面、一次性评估。设置：美国2001年秋季。文章：一个由两名医生、两名临床药剂师和一名DDIS专家组成的专家小组。干预：系统回顾药物相互作用概要和已发表的文献，对DDIS的临床各个方面(如临床重要性、证据的质量和数量、因果关系、发病率和死亡率)进行评级(1-10分)，和一个改进的德尔菲共识建立过程。主要结果衡量：专家小组成员对DDS临床重要性的意见。结果：专家小组考虑了56个DDI。在这些患者中，28人的平均临床重要性评分为8.0或更高。临床重要性的评分范围从3.2到9.6，在所检查的组合中，平均+/-SD为7.5+/-1.5。表明存在交互作用的文献质量的平均得分在1.0到9.6之间，平均+/-SD为5.8+/-2.5。就评估的互动情况而言，平均+/-SD评分为6.3+/-2.2，范围为1.4至9.2。通过改进的德尔菲法，该小组确定了25种临床重要的药物相互作用。结论：使用专家小组和标准评估工具，确定了25种可能发生在社区和门诊药房环境中的临床重要药物相互作用。药剂师应该采取措施，防止患者接受这些相互作用的药物，计算机软件供应商应该将交互警报集中在这些和类似重要的DDIS上。
OBJECTIVE: To develop a list of clinically important drug-drug interactions (DDIs) likely to be encountered in community and ambulatory pharmacy settings and detected by a computerized pharmacy system.DESIGN: Cross-sectional, one-time evaluation.SETTING: United States in fall 2001.PARTICIPANTS: An expert panel comprising two physicians, two clinical pharmacists, and an expert on DDIs.INTERVENTIONS: Systematic review of drug interaction compendia and published literature, ratings (on a 1 to 10 scale) of various clinical aspects of DDIs (e.g., clinical importance, quality and quantity of evidence, causal relationship, risk of morbidity and mortality), and a modified Delphi consensus-building process.MAIN OUTCOME MEASURE: Panelists' opinions about clinical importance of DDIs.RESULTS: The expert panel considered 56 DDIs. Of these, 28 had a mean clinical importance score of 8.0 or more. The ratings for clinical importance ranged from 3.2 to 9.6, with a mean +/- SD of 7.5 +/- 1.5 across the combinations examined. The mean score for the quality of literature suggesting the interaction exists ranged from 1.0 to 9.6, with a mean +/- SD of 5.8 +/- 2.5. In terms of substantiation of the interactions evaluated, the mean +/- SD rating was 6.3 +/- 2.2, with a range from 1.4 to 9.2. Through the modified Delphi process, the panel determined that 25 interactions were clinically important.CONCLUSION: Using an expert panel and a standard evaluation tool, 25 clinically important drug interactions that are likely to occur in the community and ambulatory pharmacy settings were identified. Pharmacists should take steps to prevent patients from receiving these interacting medications, and computer software vendors should focus interaction alerts on these and similarly important DDIs.