• 作者：Julio J. Ló ; pez-Picazo^a ; ^{julioj.lopez-picazo@carm.es} ; Juan C. Ruiz^b ; José ; F. Sá ; nchez^c ; Á ; ngeles Ariza^d ; Belé ; n Aguilera^e
• 关键词：Atenci&oacute ; n Primaria ; Seguridad de Medicamentos ; Priorizaci&oacute ; n
• 刊名：Atenci贸n Primaria
• 出版年：2011
• 期刊代码：pca69_02126567
• 类别：med
• 出版时间：May 2011
• 卷：43
• 期：5
• 页码：254-262
• 文件大小：214 K

class="h4">Objective

To effectively locate the drugs most implicated in severe interactions as a basis of designing actions to improve patient safety in Primary Care.

class="h4">Design

Cross-sectional study of prescriptions using the Primary Care computerised medical records database (OMI-PC).

class="h4">Setting

Murcia (Spain) Health Areas I, VI, VII and IX (723,664 inhabitants).

class="h4">Participants

There are 362,271 patients over 14 years-old available in the OMI-PC and are assigned to a doctor who uses the OMI-PC regularly.

class="h4">Main measurements

We analysed the drugs that each patient could be taking, looking for severe interactions. We constructed a severe interaction hazard scale (e-PIG) calculating [1] the probability that a non-selected patient may be taking a particular drug and [2] the probability that a drug may produce a severe interaction. With this, we estimated the risk of producing a severe interaction for each drug, which was converted into a 5 point logarithmic scale.

class="h4">Results

We found 83,138 patients (22.9%) at risk (they took 2 or more drugs). We identified 466,940 prescriptions providing 939 drugs and 5,597 severe interactions (prevalence 5.8%). In these, 167 drugs were involved, of which e-PIG identified 5 (3%) with an extreme value: omeprazole, diazepam, acenocoumarol, ibuprofen and calcium.

class="h4">Conclusions

e-PIG is a logarithmic expression of the risk that prescribing a particular drug may produce a severe interaction in a determined setting and time. Its monitoring could become a prioritisation element that may assist the design of strategies for improving the safety of the use of drugs.