1.Meta-analysis of the effects of SLCO1B1 gene polymorphisms on the efficacy and safety of rosuvastatin
Chunyun LU ; Song WANG ; Kefeng LIU ; Ying XUE ; Juanjuan CHEN ; Yuanxia ZHAO ; Shuzhang DU
China Pharmacy 2024;35(19):2397-2403
OBJECTIVE To study the correlation between SLCO1B1 (521T>C and 388A>G) gene polymorphisms and the efficacy and safety of rosuvastatin. METHODS Retrieved from PubMed, Embase, Cochrane Library, PharmGKB, CNKI database and Wanfang database, the studies about the effects of 521T>C and 388A>G gene polymorphisms on the efficacy and safety of rosuvastatin were collected during the inception to Dec. 2023. The included data were analyzed by using RevMan 5.3 software. RESULTS A total of 16 studies were included. The results of meta-analysis showed that 521T>C gene polymorphism was significantly correlated with the efficacy of rosuvastatin. In the dominant gene model, compared with TT genotype, CC+TC genotype significantly improved the efficacy of rosuvastatin in raising high-density lipoprotein cholesterol (HDL-C) [MD=2.38, 95%CI(0.61,4.16), P=0.009 0]. In the homozygous gene model, compared with TT genotype, CC genotype significantly improved the efficacy of rosuvastatin in reducing total cholesterol [MD=-7.50,95%CI(-13.05, -1.95), P=0.008 0]. In heterozygous gene model, compared with TT genotype, TC genotype significantly improved rosuvastatin in reducing low-density lipoprotein cholesterol (LDL-C) [MD=-5.14, 95%CI(-9.74, -0.53), P=0.03] and increasing HDL-C [MD=5.67, 95%CI 232102311200) (2.61, 8.73), P=0.000 3]. 388A>G gene polymorphism was also significantly correlated with the efficacy of rosuvastatin. In dominant or homozygous gene models, compared with AA E-mail:dushuzhang911@163.com genotype, GG+AG genotype [MD=-6.88, 95%CI (-7.46,-6.30),P<0.000 1] or GG genotype [MD=-9.23, 95%CI(-9.41, 9.04), P<0.000 1] significantly improved the efficacy of rosuvastatin in lowering LDL-C. In the heterozygous gene model, compared with AA genotype, AG genotype significantly improved the efficacy of rosuvastatin in lowering LDL-C [MD=-3.00, 95%CI(-3.19, -2.82), P<0.000 1], total cholesterol [MD=-5.80, 95%CI(-6.00, -5.59), P<0.000 1] and triglyceride [MD=-11.79, 95%CI(-19.57, -4.02), P=0.003 0]. In the recessive gene model, compared with AA+AG genotype, GG genotype significantly improved the therapeutic efficacy of rosuvastatin in reducing LDL-C[MD=-4.31, 95%CI(-8.47, -0.14), P=0.040 0] and elevating HDL-C [MD=4.49, 95%CI (2.20, 6.77), P=0.000 1]. Under 4 gene models, there was a significant correlation between 521T>C gene polymorphism and rosuvastatin-related ADR probability (P<0.05), but no significant correlation was found in 388A>G gene polymorphism (P>0.05). CONCLUSIONS The polymorphism of 521T>C gene is significantly related to the efficacy and safety of rosuvastatin in lowering lipid, and the C allele may be one of the factors leading to the increase of rosuvastatin in lipid-lowering efficacy and ADR. 388A> G gene polymorphism is significantly associated with the lipid-lowering efficacy of rosuvastatin, but not with its safety.
2.Establishment of evaluation index system for the effectiveness of cough and wheeze pharmaceutical care clinic among asthma patients
Juanjuan CHEN ; Song WANG ; Yanfang WANG ; Mingjie YAO ; Shuzhang DU ; Baozhan CHEN
China Pharmacy 2024;35(21):2684-2689
OBJECTIVE To construct an evaluation index system for the effectiveness of cough and wheeze pharmaceutical care clinic (CWPC) among asthma patients, and to provide assessment tools and a theoretical basis for improving the control level of asthma patients and standardizing pharmaceutical care. METHODS Literature analysis and semi-structured interviews were used to establish the evaluation index system for the effectiveness of CWPC among asthma patients. Delphi method was used to conduct two rounds of expert correspondence consultation, and the index weights were determined by the analytic hierarchy process. The reliability and validity of the constructed index system were analyzed by questionnaire. RESULTS Totally 29 experts from three disciplines of medicine, pharmacy and nursing were selected from the third-grade class A hospitals in Henan province. After two rounds of expert correspondence consultation, the effectiveness evaluation index system of CWPC asthma patients (including 9 sub- dimensions, such as lung function, symptoms; 35 measurement items, such as wheezing and respiratory rate) was finally determined from three core dimensions of structure level, function level and literacy management level, and the weight value of each dimension index was determined. The results of the reliability and validity analysis confirmed the scientific rationality of the index system. CONCLUSIONS The constructed CWPC effectiveness evaluation index system for asthma patients has a high degree of recognition, reliability and validity, and can be used as a measurement tool for the effectiveness evaluation of asthma patients.
3.Research hotspots and trends on potentially inappropriate medication from 2012 to 2021
Gaoxing QIAO ; Yaojuan CHU ; Chong LIU ; Shujuan WANG ; Kefeng LIU ; Shuzhang DU
China Pharmacy 2023;34(3):370-375
OBJECTIVE To quantitatively and qualitatively analyze the progress of potentially inappropriate medication (PIM) research by means of bibliometrics, and to predict the hotspots and trends of PIM, so as to provide reference for PIM research in China. METHODS The research literature related to PIM were searched from Web of Science core database, and the publication trend of the literature was analyzed on the bibliometric online analysis platform and CiteSpace 5.8.R3 software. The research results were visualized and analyzed, and the research hotspots of PIM were summarized through gCLUTO. RESULTS About PIM research, the annual number of the literature issued from 2012 to 2021 showed a continuous growth trend totally; the United States had the largest number of literature (241 pieces); the University of Sydney in Australia was the research institution with the largest number of literature (59 pieces); O’Mahony D from University College Cork, Ireland, published the most literature (23 pieces); the research of PIM involved 57 disciplines, among which there was the largest number of literature about gerontology (384 pieces); International Journal of Clinical Pharmacy was the journal with the largest number of literature (61 pieces); Journal of the American Geriatrics Society was cited most frequently (1 197 times). The hotspots of PIM research mainly focused on seven aspects: the standard of PIM, the safety and economy research of PIM, the risk factors research of PIM, the PIM research of chronic patients, the PIM research of antipsychotics, the research of pharmacists’ participation in PIM management, and the PIM research about palliative care of tumor patients. CONCLUSIONS The heat of research on PIM has been on the rise, and there is little cooperation between countries and institutions, and more cooperation is needed. In the future, the focus of Chinese pharmacists’ research on PIM may be on the deep localization of PIM standards, PIM intervention and precise medication guidance, and PIM management of specific diseases and drugs.
4.Clinical observation of 9 cases of rituximab followed by belimumab in the treatment of severe systemic lupus erythematosus
Yuanxia ZHAO ; Guanmin GAO ; Xiaojing LU ; Yaojuan CHU ; Song WANG ; Xiangfen SHI ; Shuzhang DU ; Xiaojian ZHANG
China Pharmacy 2023;34(7):849-853
OBJECTIVE To investigate the clinical efficacy and safety of rituximab (RTX) followed by belimumab (BLM) in patients with severe systemic lupus erythematosus(SSLE). METHODS Nine SSLE patients, who were treated with RTX followed by BLM for more than 6 months in the Department of Rheumatology and Immunology of the First Affiliated Hospital of Zhengzhou University from October 2020 to June 2021, were enrolled. Baseline clinical data of patients, laboratory examination results and basic treatment status at weeks 0, 4, 12, and 24 of medication were collected retrospectively. The patients’ systemic lupus erythematosus disease activity index (SLEDAI) score, glucocorticoid dosage and serological indicators (complement C3, complement C4, serum albumin, and 24-hour urine protein quantification) level were analyzed. At the same time, the occurrence of adverse drug reaction was collected. RESULTS All 9 patients completed more than 24 weeks of RTX followed by BLM therapy. All patients suffered from renal impairment, of which 7 (77.8%) had renal pathology support, 3(33.3%) had blood system damage and 2 (22.2%) had nervous system damage. During treatment, with the prolongation of treatment time, the SLEDAI score, 24- hour urinary protein quantification, and glucocorticoid dosage of patients showed a significant downward trend, and ultimately decreased to the normal index level (P<0.05); serum albumin, complement C3 and complement C4 all showed a significant upward trend, eventually rose to the normal index level (P<0.05). During treatment and follow-up, 1 patient developed herpes zoster, 1 patient developed upper respiratory tract virus infection, and 1 patient developed urinary system bacterial infection. All patients recovered after symptomatic treatment. CONCLUSIONS In sequential use of RTX followed by BLM for SSLE, early administration of RTX can quickly stabilizethe condition, significantly alleviate clinical symptoms, and gradually normalize specific serological indicators; subsequent administration of BLM can reduce the type and dosage of basic treatment drugs; there is no increase in the incidence of adverse drug reactions.
5.Construction of evaluation index system for scientific research ability of hospital pharmacists and analysis of its reliability and validity
Yanfang WANG ; Juanjuan CHEN ; Kelei GUAN ; Xiangfen SHI ; Kefeng LIU ; Jing WANG ; Song WANG ; Shuzhang DU
China Pharmacy 2023;34(2):242-245
OBJECTIVE To construct the evaluation index system for scientific research ability of hospital pharmacists, and provide reference for the improvement of hospital pharmacists’ scientific research ability and the formulation of relevant scientific research policies. METHODS The relevant indexes of scientific research evaluation of hospital pharmacists were extracted by literature analysis, and consultation questionnaire was designed according to Likert grade 5 scoring method. Delphi method was used to conduct two rounds of questionnaire consultation for 28 experts, and the weight of each index was determined by analytic hierarchy process. The reliability and validity of index system were analyzed by questionnaire survey. RESULTS After two rounds of expert correspondence, evaluation index system for scientific research ability of hospital pharmacists was finally determined from three core dimensions: basic scientific research ability, scientific research achievements and transformation ability, academic influence and personnel training (including 11 sub-dimensions and 34 measurement items). The weight value of each dimension index was determined. The result of reliability and validity analysis confirmed the scientific rationality of the index system. CONCLUSIONS The established evaluation index system for scientific research ability of hospital pharmacists is innovative, comprehensive and scientific. The index system model can provide reference for the improvement of hospital pharmacists’ scientific research ability and the formulation of relevant scientific research policies.
6.Development of the index system of the quality evaluation standard for pharmacist training in cough and wheeze pharmaceutical care outpatient department
Yanhui GE ; Xiaoli CHEN ; Xiaoyu ZHAO ; Zhe CHEN ; Kelei GUAN ; Shuzhang DU
China Pharmacy 2023;34(21):2649-2653
OBJECTIVE To establish the index system of quality evaluation standard for pharmacist training in cough and wheeze pharmaceutical care (CWPC) outpatient department, and to provide a basis for the selection of CWPC pharmacist training teachers and the improvement of training plans. METHODS Based on Kirkpatrick model, using the Delphi method, a total of 15 experts from 13 tertiary hospitals in 10 provinces in China were consulted to establish the standard index system of the quality evaluation for CWPC pharmacists training. Analytic hierarchy process (AHP) was adopted to determine the weights of each indicator and quantify the index system according to the weights of indicators at all levels. RESULTS The coefficient of expert authority was 0.810, the judgment coefficient was 0.727, and the familiarity coefficient was 0.893. The Kendall coordination coefficient of each index was 0.308-0.687. The P values of χ2 test were all less than 0.05, which indicated that the degree of coordination of the experts was high. After two rounds of correspondence, Kirkpatrick model-based index system of quality evaluation standard for CWPC pharmacist training was determined. The index system included 4 first-level indexes (participants’ reaction layer, learning gain layer, behavior improvement layer, training outcome layer), 12 second-level indexes (such as training needs, teaching methods, theoretical knowledge, practical skills, job abilities, patient benefits, etc.) and 44 third-level indexes (such as clear training objectives, core system of CWPC, special device operation and evaluation, professional knowledge related to the treatment of cough and wheeze patients, promoting the construction of CWPC, improving patient compliance). CONCLUSIONS The constructed index system of quality evaluation standard for CWPC pharmacist training has a certain level of authority and scientificity, and provides a scientific theoretical basis for quality evaluation of CWPC pharmacist training.
7.Visual analysis of tyrosine kinase inhibitors in HER2 positive breast cancer
Jing ZOU ; Yaojuan CHU ; Qiuzheng DU ; Heying YUE ; Xiaobao WANG ; Shuzhang DU
China Pharmacy 2023;34(24):3036-3041
OBJECTIVE To analyze the research status, hotspot and development trend of tyrosine kinase inhibitors (TKIs) in the treatment of human epidermal growth factor receptor 2 (HER2) positive breast cancer. METHODS The literature related to TKIs in the treatment of HER2 positive breast cancer were searched from the Web of Science core collection database; the author, country/region, institution, subject field, journal and keywords was visualized by CiteSpace 6.1.R3 software. RESULTS A total of 732 pieces of literature were included, and the number of literature published showed an increasing trend year by year. The number of literature published in the United States was the largest (center degree 0.10), and the number of literature published in China ranked second (center degree 0.05). The most published and cited authors were Crown from St. Vincent’s University Hospital in Australia and Slamon from University of California, Los Angeles in the United States; the institution with the highest number of literature was the University of Texas MD Anderson Cancer Center, and the journal with the highest number of literature was the Journal of Clinical Oncology. The research mainly focused on five aspects: HER2 positive breast cancer treatment drugs, TKIs receptor, TKIs mechanism of action, HER2 positive breast cancer brain metastasis, and TKIs clinical trials. The main frontier areas and development trends were the combination of TKIs with other drugs or therapies to enhance targeting and reduce toxic side effects. CONCLUSIONS The study of TKIs in the treatment of HER2 positive breast cancer has attracted the attention of scholars at home and abroad. Chinese scholars and research teams need to strengthen cooperation and communication in the future, and cooperation with other countries should be strengthened in terms of the efficacy and safety of TKIs alone and combined with other drugs in the treatment of HER2 positive breast cancer.
8.Application of parameter assignment method in the review of parenteral nutrition prescription in our hospital
Jian KANG ; Huijuan NIE ; Xiaoxu CHEN ; Yanhui CHAO ; Xiaoyan ZHOU ; Gaoxing QIAO ; Shengli LIU ; Shuzhang DU
China Pharmacy 2022;33(22):2807-2811
OBJECTIVE To provide reference for improving the working efficiency of prescription review for pharmacists and ensuring the safe use of parenteral nutrition solution in patients. METHODS The review module of parenteral nutrition prescription was developed with the pharmacy intravenous admixture services(PIVAS) MATE system. According to the instructions and relevant information of parenteral nutrition solution, the parameters to the review module for parenteral nutrition solution prescriptions were assigned, thresholds and calculation formulas were set, and the prescription was automatically determined by the system. The type and quantity of the inappropriate prescriptions of parenteral nutrition solution in our hospital from January to August 2020 and from January to August 2022 were counted, and the review efficiency of inappropriate prescriptions was compared before and after the application of the review module of parenteral nutrition solution prescription. RESULTS The module realized the informatized review of basic attribute parameters and custom parameters of parenteral nutrition solution prescription, such as ion concentration, ratio of heat to nitrogen, ratio of sugar to lipid, glucose concentration, ratio of sugar to insulin, maximum dosage of compound preparation, necessary drug collocation, incompatibility, repeated drug use, age limit, etc. The module also shortened the review time greatly. It took about 33 minutes for two pharmacists to review 100 prescriptions, and only took 6 seconds after the module went online. Compared with January to August in 2020, the average approval rate of inappropriate prescriptions for parenteral nutrition solution increased from 0.582% to 1.416% during the corresponding period in 2022 (P<0.05). CONCLUSIONS The review module of parenteral nutrition solution prescription established by parameter assignment method in our hospital can greatly reduce the phenomenon of missed and wrong review by pharmacists, reduce the risk of parenteral nutrition solution dispensing, reduces the work pressure of pharmacists reviewing prescriptions, and ensures the drug safety of patients.
9.Analysis on research status and hot spots of gabapentinoid drugs in the treatment of pain
Xiaojing LU ; Xiangfen SHI ; Fangying SI ; Yuanxia ZHAO ; Jinyuan XING ; Xufeng ZHANG ; Xiaoyu ZHAO ; Shuzhang DU
China Pharmacy 2022;33(8):996-1002
OBJECTIVE To analyze the si tuation and hot spots of gabapentinoid drugs in the treatment of pain. METHODS Related researches about gabapentinoid drugs in the treatment of pain were retrieved from Web of Science core collection database during Jan. 1st,2011-Dec. 31st,2020. VOSviewer 1.6.17,CiteSpace 5.8.R1 and Excel 2018 software were used to statistically analyze the key characteristics of relevant literature ,such as the annual publications ,countries/regions,institutions,authors, journals and research hot spots. RESULTS & CONCLUSIONS A total of 3 519 literatures were retrieved ,and the annual publication outputs showed an upward trend generally. Totally 86 countries/regions had conducted relevant studies ,of which the United States ranked first (up to 1 219),and had close cooperation with the United Kingdom ,Canada,China,Germany,Japan, etc;a total of 3 996 institutions had published relevant literatures ,and the Pfizer Inc. issued the most publications ;the most studies were devoted by Professor Parsons from the University of California San Diego ,and the highest co-citations author was Professor Gilron from the Queen ’s University. Among 1 185 journals,Pain ranked first not only in the high-productive journal ,but also in the co-cited journal. The main hot topics include abuse and misuse of gabapentinoid ,off-label use of gabapentinoid ,clinical application of gabapentinoid as a component of multimodal analgesia ,and the update of guidelines for pain based on systematic evaluation and meta-analysis.
10.Analysis of the situation ,influential factors and their relationship of hospital pharmacy managers ’servant leadership behavior and hospital pharmacists ’job satisfaction
Yaojuan CHU ; Zhao YIN ; Yan LIANG ; Rui ZHANG ; Gaoxing QIAO ; Jie HAO ; Chong LIU ; Ting YANG ; Shuzhang DU
China Pharmacy 2022;33(3):366-371
OBJECTIVE To investigate the situation ,influential factors and their re lationship of hospital pharmacy managers ’ servant leadership behavior and hospital pharmacists ’job satisfaction. METHODS The questionnaire survey method was adopted to stratified cluster sampling from primary ,secondary and tertiary hospitals ,five for each in Henan province. The personal basic data scale of pharmacists ,the hospital pharmaceutical service leadership behavior scale and the job satisfaction scale of pharmacists were used to conduct a questionnaire survey among hospital pharmacists. Excel 2019 and SPSS 23.0 software were used for statistical analysis. RESULTS A total of 956 questionnaires were distributed and 882 questionnaires were recovered ,including 841 valid questionnaires,with an effective recovery rate of 95.35%. The reliability coefficients Cronbach’s α of hospital pharmacy managers ’ servant leadership behavior scale and hospital pharmacists ’job satisfaction scale were 0.986 and 0.978,and the validity coefficients KMO were 0.908 and 0.977(P<0.01). The total score of hospital pharmacy managers ’servant leadership behavior was (110.73± 18.63). The total score of hospital pharmacists ’job satisfaction was (126.33±17.79). Hospital grade ,gender,age,professional title and highest education level all affected pharmacists ’recognition for managers ’servant leadership behavior (P<0.05). Hospital grade,age,professional title ,marital status ,highest education level and position all affected job satisfaction (P<0.05). The servant leadership behavior of hospital pharmacy managers was positively correlated with the job satisfaction of hospital pharmacists (correlation coefficient r was 0.521-0.698,all P<0.01). CONCLUSIONS The promotion and optimization the servant leadership behavior of hospital pharmacy managers can improve the job satisfaction of pharmacists ,stabilize the team of pharmacists ,and provide high-quality pharmaceutical care for patients ,so as to improve the core competitiveness of the hospital.
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