摘要
目的探讨老老年患者中药物相互作用的发生状况及对于临床用药安全的影响。方法随机选取同济大学附属东方医院老年医学科2007年7月至2009年7月大于80岁患者为研究对象。研究分为2阶段,智能化用药监测系统(Intelligent Prescription Automatic Screening System)于第2阶段介入干预。统计药物相互作用类型及次数,根据Naranjo评分表,判定由其引起的药物不良反应事件(adverse drug events,ADEs)。比较2阶段ADEs发生率、分布及严重程度,发生可预防ADEs患者的住院时间、住院费用的差异。结果研究期间统计80例药物相互作用事件,导致ADEs47例。智能化监测系统干预治疗前后,ADEs及可预防的ADEs的发生率均有所下降,并且差异具有统计学意义(P<0.001)。对47例可预防ADEs的平均住院时间和平均住院费用进行统计学分析,结果表明使用智能化监测系统前后两组数据差别有统计学意义(P<0.05)。结论老老年人群中,药物相互作用普遍存在,极易导致ADEs,且多为可预防事件。使用智能化监测系统介入干预,可有效降低可预防ADEs发生,缩短住院时间,降低住院费用,减少医疗隐患,降低病残率,提高临床用药安全。但其存在一定缺陷。
Objective To assess the application of Intelligent Prescription Automatic Screening System for monitoring drag-drag interactions in elderly patients.Methods Elderly patients（80 y） from Gerontology Department,East Hospital admitted from July 2007 to July 2009 were selected randomly.The adverse drug events（ADEs） were defined according to Naranjo score.The type and frequency of drag interaction and ADEs were determined.The incidence,distribution,and severity of ADEs,and hospitalization duration and cost of preventable ADEs were compared,before and after intervention with intelligent prescription screening system was applied.Results Eighty cases of drug-drag interaction were identified,which result in 47cases of ADEs.The incidence of preventable ADEs and severe preventable ADEs decreased after intervention（P0.01）.Hospitalization duration and hospitalization costs for preventable ADEs decreased significantly（P0.05） after intervention.Conclusion Drug-drug interaction is common in elderly in-patients.Intervention of intelligent prescription screening system can be beneficial to clinical results,including shortening hospitalization duration,lowering hospital costs,reducing medical risks, reducing morbidity,and improving clinical safety.
出处
《同济大学学报（医学版）》
CAS
2011年第5期72-76,共5页
Journal of Tongji University(Medical Science)
基金
上海市科委重点科技支撑计划(08411951300)
关键词
老老年人
药物相互作用
药物不良事件
智能化用药监测系统
elderly patients
drug interaction
adverse drug events
Intelligent Prescription Automatic Screening System
