Study on Contraindicated Drug-Drug Interactions in Pharmaceutical Management of Antiviral Therapy
Objective:To evaluate and explore the impact of pharmaceutical management projects on the contraindicated drug-drug interactions (DDIS) in the treatment of direct-acting antiviral drugs (DAAs),with a view to providing reference for clinical pharmacy. Methods:A total of 200 patients with hepatitisc who received DAA treatment in our hospital from January 2020 to January 2023 were selected as the research subjects. Pharmacists screen all these C patients for DDIS before DAA treatment. The research results include the frequency,acceptance rate,and cost savings of contraindicated DDIS in drug management plans. Result:The mean age of the 200 patients included was (67.1±11.9) years old,and the most common treatments for DDI and DAA were proton pump inhibitors/histamine-2 receptor antagonists (27％),calcium channel blockers (19％),and statins (16％). The incidence of contraindicated DDIS was 2％ (n=4) and the incidence of potentially clinically significant interactions was 22％ (n=44),for a total of 48 cases. Rosuvastatin (38％,18/48),atorvastatin (18％,8/48) and amiodarone (9％,4/48) is the most frequently used drug. For DDIS with contraindications and poten-tially clinically significant interactions,the most common pharmacist recommendation was to "change the drug" (93％,45/48),with an overall clinician acceptance rate of 70％ (33/48),and the choice of another DAA without contraindications was a common clinical option. Two clinical pharmacists and two hepatologists independently reviewed four cases of contraindicated DDIS and 44 cases of DDIS with potential clinically meaningful interactions. Through pharmacentical management,the estimated number of days admitted to hospital for ADE was reduced by 84.2 d,and the estimated avoided cost of preventable ADE was 14033 yuan. Conclusion:The implementation of drug management plan in DAA treatment provides good results and substantial cost savings,which is worth promoting in clinical pharmacy.
Pharmaceutical managementContraindicated drygAntiviral therapyHepatitis C
万方数据
维普
