Szkultecka-Dębek Monika, Bułaś Lucyna, Skowron Agnieszka, Drozd Mariola
University of Social Sciences, 00-842 Warsaw, Poland.
Department of Pharmaceutical Technology, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland.
J Clin Med. 2025 Sep 5;14(17):6263. doi: 10.3390/jcm14176263.
Managing the therapy of patients with chronic liver diseases and comorbidities presents significant challenges for physicians and pharmacists, particularly regarding drug-induced liver damage and polypharmacy. Given the liver's central role in drug detoxification, polypharmacy in liver disease requires special attention. The aim of the review was to assess the prevalence of polypharmacy among patients with chronic liver diseases. A literature search focused on randomized controlled trials, database reviews, and medical records. Review of PubMed, SCOPUS, and ScienceDirect databases identified 2578 manuscripts, however only 11 studies met the inclusion criteria. The results of studies showed that the prevalence of polypharmacy among patients with chronic liver disease can exceed 50%, and can lead to high prevalence of MRP and pDDI among those patients. Findings reveal a critical link between polypharmacy and adverse outcomes in chronic liver diseases, including cirrhosis, hepatitis, and non-alcoholic fatty liver disease. Individualized treatment plans, considering factors such as age, gender, comorbidities, and liver disease severity are essential. The interventions focused on mitigating MRP and reducing pDDI need to be implemented in order to reduce the potential harm of polypharmacy.
对患有慢性肝病及合并症的患者进行治疗管理,给医生和药剂师带来了重大挑战,尤其是在药物性肝损伤和多重用药方面。鉴于肝脏在药物解毒中起核心作用,肝病患者的多重用药需要特别关注。本综述的目的是评估慢性肝病患者中多重用药的患病率。文献检索集中于随机对照试验、数据库综述和医疗记录。对PubMed、SCOPUS和ScienceDirect数据库的检索共识别出2578篇手稿,但只有11项研究符合纳入标准。研究结果表明,慢性肝病患者中多重用药的患病率可能超过50%,并可能导致这些患者中多重用药问题(MRP)和潜在药物相互作用(pDDI)的高发生率。研究结果揭示了多重用药与慢性肝病(包括肝硬化、肝炎和非酒精性脂肪性肝病)不良结局之间的关键联系。考虑年龄、性别、合并症和肝病严重程度等因素的个体化治疗方案至关重要。需要实施旨在减轻多重用药问题和减少潜在药物相互作用的干预措施,以降低多重用药的潜在危害。