血液病造血干细胞移植患者门诊随访中药物相关问题的网络分析OA

AIM Network analysis was conducted to systematically analyze the relationship between causative drugs and types of drug-related problems(DRPs)in outpatients with hematological diseases after hematopoietic stem cell transplantation(HSCT).METHODS A retrospective analysis method was used to analyze DRPs in outpatients with HSCT from November 2023 to October 2024.DRPs were classified into 6 sub-domains for problems and 38 sub-domains for causes according to Pharmaceutical Care Network Europe(PCNE)classification.Causative drugs were classified by the Anatomical Therapeutic Chemical(ATC)code.Network analytic tool was used to represent the relationship between drugs,causes,and problems.In-degree centrality(CD-in)was calculated to identify major causes of DRPs.RESULTS A total of 245 DRPs were identified.The following drugs accounted for more than 5％of DRP,including immunosuppressants(L04,21.43％),antineoplastic agents(L01,10.32％),systemic antifungal agents(J02,6.75％),and systemic antibacterial agents(J01,5.56％).The causes of DRPs in outpatients after HSCT were varied.Adverse drug reactions after correct medication of immunosuppressants or antineoplastic agents(C9.2,CD-in of 41)were major causes of DRPs.Patients unintentionally administered or used immunosuppressants or antimycotics incorrectly(C7.8,CD-in of 16),resulting in reduced effectiveness.The high dose of immunosuppressants or antineoplastic agents(C3.2,CD-in of 16)increased adverse drug events.CONCLUSION Clinical pharmacists should check carefully to avoid missing DRPs.More attention should be paid to recognizing adverse drug reactions and taking dose adjustments of immunosuppressants and antineoplastic agents,and improving the compliance and correctness of immunosuppressive and antifungal agents.