重症监护病房中潜在药物相互作用识别的异质性：系统回顾、严格评估和报告建议
2023-10-02 Equator Network J Clin Pharmacol. 2022 Jun; 62(6): 706–720 发表于加利福尼亚
入住重症监护病房 (ICU) 的患者经常暴露于潜在的药物相互作用 (pDDI)。 然而，不同研究报告的 ICU 中 pDDI 发生率差异很大。 这可以部分地通过他们的方法论的显着差异来解释。 深入了解
重症监护病房中潜在药物相互作用识别的异质性：系统回顾、严格评估和报告建议
2023-10-02
入住重症监护病房 (ICU) 的患者经常暴露于潜在的药物相互作用 (pDDI)。 然而，不同研究报告的 ICU 中 pDDI 发生率差异很大。 这可以部分地通过他们的方法论的显着差异来解释。 深入了解影响 pDDI 频率的方法选择将有助于改进报告的 pDDI 频率的比较和综合。 本研究旨在评估方法选择与 pDDI 频率之间的关联，并为 ICU 中的 pDDI 频率研究制定报告建议。 搜索 MEDLINE 数据库以识别报告 ICU 患者 pDDI 频率的论文。 对于每篇论文，提取 pDDI 频率和方法选择（例如 pDDI 定义和 pDDI 知识库），并评估偏倚风险。 每篇论文都被分类为报告低、中或高 pDDI 频率。 我们寻找方法选择和 pDDI 频率组之间的关联。 根据这一比较，制定了报告建议。 方法学选择分析显示研究之间存在显着异质性，65% 的研究存在中度至高度偏倚风险。 高偏倚风险、小样本量以及使用药物处方而不是给药与较高的 pDDI 频率相关。 本综述的结果可能支持研究人员设计一种可靠的方法来评估 ICU 患者的 pDDI 频率。 报告建议可能有助于 pDDI 频率研究的标准化、比较和综合，最终提高有关 ICU 内外 pDDI 的知识。
Summary of Recommendations for Reporting the Frequency of pDDIs in the ICU
| Section/Topic | ||
|---|---|---|
| Methods | Item No. | Item |
| ICU type | 1 | Describe the type of the ICU(s) the patient sample was drawn from. |
| Set of pDDIs | 2 | Describe the set of pDDIs evaluated in the study. Indicate which pDDI knowledge base was used to detect these pDDIs. Indicate whether a selection of pDDIs was made based on clinical relevance, severity level, pDDI type, or any other factor. |
| Set of drugs | 3 | Describe the set of drugs included in the evaluation of pDDIs. Indicate whether a selection of drugs was made on the basis of medication type, medical indication, or any other factor. |
| Drug data source | 4 | Describe the drug data source on which pDDI detection was performed, for example, drug orders, clinical notes. Clearly indicate whether drug prescriptions or drug administrations were used. |
| Detection algorithm | 5 | State the process for detecting pDDIs and indicate whether the process was manual or automated. |
| pDDI definition | ||
| Gap time | 6 | Specify what time restrictions were used to define a pDDI. Indicate whether drugs should be given simultaneously or that a gap time is used to deem them a pDDI. Indicate whether the gap time takes half‐life into account. Specify the gap time, for example, 24 h. |
| Counting of the pDDIs | 7 | Describe how pDDIs were counted, indicate whether specific pDDIs or pDDI types were counted, and indicate whether a pDDI was counted more than once in 1 patient. |
| Restrictions admission days | 8 | Specify if pDDI detection was restricted to specific admission day(s). |
| Restrictions length of stay | 9 | Indicate whether patients were excluded on the basis of restrictions regarding their ICU length of stay. |
| pDDI prevention strategies | 10 | Describe if the ICU uses any type of pDDI prevention strategy, such as a computerized decision support system. |
| Results | ||
| Number of patients | 1 | Report the number of patients in the patient sample. |
| Participants | 2 | Characterize the patient sample in terms of relevant variables, for example, age, sex, diagnosis, comorbidities, (predicted) mortality. |
| Number of pDDIs | 3 | Report the total number of pDDIs detected. |
| Number of patients with at least 1 pDDI | 4 | Report the number and percentage of patients with at least 1 pDDI. |
| Number of drugs | 5 | Report the total number of drugs evaluated. |
| Total length of stay | 6 | Report the total length of stay of all patients in days. |
ICU, intensive care unit; pDDI, potential drug‐drug interaction.
JCPH-62-706.pdf
