老年人潜在具有临床意义的药物-药物相互作用筛查标准的比较

Comparison of Criteria for Potentially Clinically Significant Drug-Drug Interaction in the Elderly

目的:对包含潜在具有临床意义的药物-药物相互作用(csDDI)的国外标准进行比较研究,为我国老年人药物治疗过程中潜在csDDI的识别提供参考。方法:提取国外常见的包含老年人csDDI标准的筛查清单相关信息,对基本信息、覆盖内容、提示的相互作用风险、相互作用类型以及处置意见等进行比较。结果:共纳入5个标准,包括Beers标准、STOPP标准、NORGEP-NH标准、GheOP^(3)S工具以及老年人潜在csDDI国际共识清单。所有标准共涉及80类csDDI,其中被5个标准覆盖的有2类,被4个标准覆盖的有2类,被3个标准覆盖的有13类,被2个标准覆盖的有12类;STOPP标准最少(6条),但与其他标准的重复率最高(100%);国际共识清单中潜在csDDI覆盖最广(66条)。结论:老年人潜在csDDI筛查标准的内容有所异同,目前尚缺乏适宜我国老年人群药物治疗过程中潜在csDDI的筛查标准以及实际csDDI发生的相关研究,丰富相关研究能为我国老年人临床合理用药提供更多依据。

OBJECTIVE:To compare foreign criteria of potentially clinically significant drug-drug interaction(csDDI),so as to provide reference for the identification of potential csDDI during drug therapy for the elderly in China.METHODS:Relevant information of common screening lists containing csDDI criteria for the elderly in foreign countries was extracted and compared with basic information,coverage content,interaction risk,interaction type and disposal suggestions.RESULTS:A total of five criteria were enrolled,including the Beers criteria,STOPP criteria,NORGEP-NH criteria,GheOP^(3)S tool and the international consensus list of potential csDDI in the elderly.All criteria covered a total of 80 categories of csDDI,of which 2 categories were covered by 5 criteria,2 categories were covered by 4 criteria,13 categories were covered by 3 criteria,and 12 categories were covered by 2 criteria.The items’number of STOPP criteria was the least(6 items),yet the repetition rate wad the highest(100%).International consensus list had the most comprehensive coverage(66 items).CONCLUSIONS:There are some similarities and differences in these five potential csDDIs criteria for the elderly.Currently,there is a lack of criteria for potential csDDIs in the drug treatment for the elderly in China and the study of actual csDDIs.Enriching relevant studies can provide more evidence for China’s rational drug use among the elderly.