The Possibility of Therapeutic Drug Monitoring of the Most Important Interactions in Nursing Homes.

IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics Current clinical pharmacology Pub Date : 2019-01-01 DOI:10.2174/1574884714666181224144722
Pernille Schjøtt, Martina Šutovská, Jan Schjøtt
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引用次数: 2

Abstract

Background: Therapeutic drug monitoring is a relevant tool in drug treatment of elderly patients. The aim of this study was to assess the possibility of therapeutic drug monitoring of the most important potential interactions in nursing homes.

Methods: A material of prescribed drugs to 446 patients in three nursing homes in Bergen, Norway from a single day in March 2016 was analysed. Clinically relevant drug interactions (pharmacodynamic or pharmacokinetic) were identified and classified with Stockley`s Interaction Alerts. The most important interaction among several in each patient were ranked by recommended action > severity > evidence according to Stockley`s. The possibility of therapeutic drug monitoring of drug combinations involved in the most important interactions was retrieved from a database of all laboratories performing clinical pharmacology in Norway (the Pharmacology Portal).

Results: Two or more drugs were used by 443 (99.3%) of 446 patients. Three-hundred and eightyfour patients (86.1%) had > 1 interaction. About 95% of the most important interactions were pharmacodynamic. In 280 (72.9%) of these interactions, Stockley`s recommended adjust dose or monitoring. Among the 384 most important interactions, 93% involved one drug and 41% involved two drugs available for therapeutic drug monitoring.

Conclusion: In this pilot study, therapeutic drug monitoring was possible in the majority of the most important interactions in Norwegian nursing homes. This option is of importance since adjust dose or monitoring were frequently recommended actions associated with these interactions.

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疗养院中最重要相互作用的治疗药物监测的可能性。
背景:治疗性药物监测是老年患者药物治疗的相关工具。本研究的目的是评估治疗药物监测疗养院中最重要的潜在相互作用的可能性。方法:对2016年3月挪威卑尔根市3家养老院446例患者的处方药品资料进行分析。临床相关的药物相互作用(药效学或药代动力学)被斯托克利相互作用警报识别和分类。根据Stockley 's,每个患者中几种最重要的相互作用按推荐行动>严重程度>证据排序。从挪威所有临床药理学实验室的数据库(药理学门户)中检索了对涉及最重要相互作用的药物组合进行治疗药物监测的可能性。结果:446例患者中有443例(99.3%)使用两种及以上药物。384例(86.1%)患者有> 1次相互作用。大约95%最重要的相互作用是药效学的。在280例(72.9%)相互作用中,斯托克利建议调整剂量或监测。在384个最重要的相互作用中,93%涉及一种药物,41%涉及两种可用于治疗药物监测的药物。结论:在这项初步研究中,治疗性药物监测在挪威养老院大多数最重要的相互作用中是可能的。这一选择很重要,因为经常建议采取与这些相互作用相关的调整剂量或监测措施。
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来源期刊
Current clinical pharmacology
Current clinical pharmacology PHARMACOLOGY & PHARMACY-
CiteScore
3.60
自引率
0.00%
发文量
0
期刊介绍: Current Clinical Pharmacology publishes frontier reviews on all the latest advances in clinical pharmacology. The journal"s aim is to publish the highest quality review articles in the field. Topics covered include: pharmacokinetics; therapeutic trials; adverse drug reactions; drug interactions; drug metabolism; pharmacoepidemiology; and drug development. The journal is essential reading for all researchers in clinical pharmacology.
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