从临床数据仓库测量累积药物暴露
Mathilde Bories1, Aurélie Bannay2, Morgane Pierre-Jean1
1Université de Rennes, CHU de Rennes, INSERM, LTSI-UMR 1099, Rennes, France.
Studies in health technology and informatics
|November 22, 2024
概括
多药和高多药在干细胞移植患者中很常见,增加了风险. 一个新的指标,累积药物暴露,量化了这种暴露及其移植类型之间的差异.
科学领域:
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
- 在瘤学瘤学.
背景情况:
- 多药性 (PP) 和高多药性 (HPP) 在癌症患者中很普遍,增加了药物相互作用 (DDI) 和潜在不适当药物 (PIM) 的风险.
- 血造干细胞移植 (HSCT) 患者经常面临复杂的药物治疗方案,需要对处方决定因素有充分的了解.
研究的目的:
- 在住院的HSCT患者中描述PP,HPP,DDI和PIM.
- 引入和评估一个新的指标:累积药物暴露,量化患者在住院期间对这些决定因素的暴露.
主要方法:
- 利用临床数据仓库 (CDW) 记录开发算法来量化累积药物暴露.
- 计算了患者在住院期间接触PP,HPP,PIM和/或DDI的日数.
- 将PIM或DDI的每日计数纳入累计风险计算中.
主要成果:
- 在339名HSCT患者中,PP和HPP的患病率很高 (>67%).
- 几乎所有患者都经历了DDI (>98%),大多数老年患者接受了PIM (>98%).
- 与异性HSCT患者相比,异性HSCT患者的HPP (28.5天与4.7天) 和DDI (255.6天与58.4天) 累积暴露显著更高.
结论:
- 累积药物暴露为评估住院期间处方决定因素的影响提供了一个全面的指标.
- 这种新的方法增强了对处方实践如何影响HSCT患者临床结果的理解.
- 这些发现为未来的研究提供了基础,将药物暴露与这种脆弱人群中的不良事件联系起来.
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