基于妊娠用药登记平台的父方药物暴露临床药学服务

Clinical Pharmacy Services for Paternal Drug Exposure Based on A Pregnancy Drug Registry Platform

目的交流国内围孕期父方用药行为及模式,探讨临床药师在父方药物暴露方面可提供的药学服务类型及作用。方法以围孕期父方药物暴露患者为服务对象,介绍临床药师基于妊娠/哺乳期药学门诊开展父方药物暴露咨询的临床实践工作模式。对咨询病例信息进行回顾性调查,分析人群药物暴露特征,并与国外致畸信息服务中心数据进行比较。结果2017年10月—2022年9月,共为门诊404例父方暴露患者提供药学咨询服务,建立标准化接诊流程。父方药物暴露咨询占比3.6%,以非计划妊娠用药最为常见(79.2%),人均暴露药品(2.6±1.7)种。咨询排名前5位药物类型为抗微生物药、中成药、心血管系统药物、消化系统药物及内分泌系统药物;使用频率最高5种药物为头孢菌素、沙坦类药物、恩替卡韦、左氧氟沙星、二甲双胍。开展妊娠结局有效随访261例,随访率81.6%,现有随访结果未提示父方药物暴露后的先天性异常信号。结论国内父方药物暴露很少受到关注,研究证据十分有限。由临床药师向公众和医疗保健人员提供基于循证证据的药物风险评估与药物治疗建议,并基于病例开展观察性研究,对促进备孕期父方用药安全具有重要意义。

Objective To communicate the paternal medication behaviors and patterns during the peri-pregnant period in China and to explore the types of pharmaceutical care services that clinical pharmacists can provide.Methods Focusing on patients exposed to paternal medication during the perinatal period,the clinical practice model of our hospital's clinical pharmacists consultation for paternal drug exposure was introduced.Furtherly,a retrospective survey on the information of consultants was conducted and the characteristics of drug exposure were analysed in this population,and a comparation made with data from foreign teratogenic information service centers.Results From October 2017 to September 2022,leveraging our hospital's Pregnancy Registration Platform for Medication,clinical pharmacists provided pharmaceutical consultation services for 404 outpatient cases of paternal exposure,and established a standardized consultation flow.Paternal exposure counseling accounted for 3.6%of cases,with medication use during an unplanned pregnancy being the most common situation(79.2%).The average number of exposed drugs was(2.6±1.7).The top five types of drugs consulted were antimicrobials,Chinese traditional patent medicine,cardiovascular system drugs,digestive system drugs and endocrine system drugs.The five most frequently used drugs were cephalosporins,sartans,entecavir,levofloxacin and metformin.Effective follow-up was conducted on 261 cases,with a follow-up rate of 81.6%,and no congenital abnormal signals were indicated after exposure to the father's medication.Conclusion Pateral drug exposure in China has received little attention,with very limited research evidence available.Clinical pharmacists providing evidence-based drug risk assessment and medication advice to the public and healthcare professionals,along with conducting observational studies based on cases,are of significant importance in promoting the the safe use of paternal medications.