GENEL PEDİYATRI SERVİSİ HASTALARINDA POTANSİYEL İLAÇ-İLAÇ ETKİLEŞİMLERİNİN SAPTANMASI: BİR KESİTSEL ÇALIŞMA

Year 2023, Volume: 47 Issue: 2, 520 - 530, 20.05.2023

Hasan Memiş , Ahmet Çakır , Nesligül Özdemir , Zeynep Ülkü Gün

https://doi.org/10.33483/jfpau.1241376

Abstract

Amaç: Bu çalışma, hastanede yatan hastalarda potansiyel ilaç-ilaç etkileşimlerini (pDDI'ler) belirlemeyi ve iki ticari ilaç etkileşimi veri tabanını karşılaştırmayı amaçlamaktadır.
Gereç ve Yöntem: Bu prospektif kesitsel çalışma, Şubat ve Mayıs 2022 tarihleri arasında üçüncü basamak bir hastanenin genel pediyatri servisinde yürütülmüştür. pDDI'leri belirlemek için UpToDate® ve Micromedex® İlaç Etkileşimi veritabanları kullanılmıştır.
Sonuç ve Tartışma: Elli bir pediatrik hastanın ilaç listesinde toplam 267 pDDI bulunmuştur (UpToDate® aracılığıyla 181 ve Micromedex® aracılığıyla 86). En az beş farklı sistemik ilacın aynı anda kullanımı, en az bir pDDI saptanmış ve saptanmamış hasta grupları arasında istatistiksel olarak anlamlıydı. İkili lojistik regresyon analizi, bir hastanın hastanede yatışı sırasında aldığı toplam ilaç sayısındaki bir ilaç artışının, pDDI olasılığını 2.12 kat artırdığını göstermiştir (GA: 1.321-3.417, p=0.002). pDDI saptnmasında UpToDate® ve Micromedex® veritabanları arasındaki uyum oranı %84.31 olarak bulunmuştur (kappa katsayısı=0.676, standart hata=0,102, (p ≤ 0.001)). UpToDate® veri tabanı referans veri tabanı olarak kabul edildiğinde, Micromedex® veri tabanının pDDI'leri belirlemedeki hassasiyeti, özgüllüğü, pozitif prediktif değeri, negatif prediktif değeri ve doğruluğu %79.41, %94.12, %96.43, %69.56 ve %84.5 idi. Bir pDDI'yı atlamaktan kaçınmak için çoklu ilaç etkileşimi veritabanlarının kullanılması faydalı olabilir.

Keywords

Çocuklar, ilaç etkileşimleri, klinik eczacı, pediyatrik hastalar

DETERMINATION OF POTENTIAL DRUG-DRUG INTERACTIONS IN GENERAL PEDIATRIC WARD PATIENTS: A CROSS-SECTIONAL STUDY

Abstract

Objective: This study seeks to identify potential drug-drug interactions (pDDIs) in hospitalized patients and compare two commercial drug interaction databases.
Material and Method: This prospective cross-sectional study was conducted between February and May 2022 in a tertiary care hospital's general pediatric ward. UpToDate® and Micromedex® Drug Interaction databases were used to determine pDDIs.
Result and Discussion: In total, 267 pDDIs were found in 51 pediatric patients' medication lists (181 via UpToDate® and 86 via Micromedex®). The use of at least five different systemic drugs concurrently was statistically significant between groups of patients who experienced at least one pDDI and those who did not. The binary logistic regression analysis showed that a one-drug increase in the total number of drugs a patient received during hospitalization increased the probability of pDDIs by 2.12-fold (CI: 1.321-3.417, p=0.002). The concordance rate between UpToDate® and Micromedex® databases for pDDI determination was 84.31% (kappa coefficient=0.676, standard error=0.102, (p ≤ 0.001)). When the UpToDate® database was assumed as a reference database, the Micromedex® database's sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in determining pDDIs were 79.41%, 94.12%, 96.43%, 69.56%, and 84.5%. To avoid missing pDDIs, utilizing multiple drug interaction databases may be of benefit.

Keywords

Children, clinical pharmacist, drug interactions, pediatric patients

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