基于德尔菲法构建老年患者抗肿瘤药物不良反应监测触发工具

doi:10.3969/j.issn.1003-9198.2026.09.009

摘要/Abstract

摘要： 目的建立老年患者抗肿瘤药物不良反应(ADR)触发工具,为老年患者抗肿瘤药物ADR的主动监测和防治提供参考。方法参考《IHI Global Trigger Tool for Measuring Adverse Events》(简称GTT白皮书)的模式,查阅药物说明书及国内外相关文献,采用德尔菲专家咨询法建立老年患者抗肿瘤药物的ADR主动监测触发工具,使用建立的触发工具随机回顾性审查2023年1—12月南通市肿瘤医院接受抗肿瘤药物治疗的老年患者的病历,评估触发工具的效能。结果通过前期准备,初步拟定50个触发条目,经过两轮德尔菲专家咨询,最终确定48个触发条目,其中实验室指标25项、临床症状12项、解毒剂9项、干预措施2项。审查的300份病历中,48个触发条目均有阳性触发,ADR检出率为67.33%(202/300),触发工具总体阳性预测值为54.01%(829/1535)。结论本研究建立的老年患者抗肿瘤药物ADR触发工具设计合理、验证有效,可为医疗机构开展老年患者抗肿瘤药物主动监测、提升临床用药安全提供参考。

关键词: 老年人, 触发工具, 德尔菲法, 抗肿瘤药物, 药品不良反应, 主动监测

Abstract: Objective To establish an adverse drug reaction (ADR) trigger tool for anti-tumor drugs in elderly patients, and to provide a reference for the active monitoring and prevention of ADRs of anti-tumor drugs in elderly patients. Methods Based on the model of the “IHI Global Trigger Tool for Measuring Adverse Events” (referred to as the GTT white paper), referring to the instructions and relevant domestic and foreign literature, using the Delphi expert consultation method, an ADR active monitoring trigger tool for anti-tumor drugs in elderly patients was established. The established trigger tool was used to randomly retrospectively review the elderly patient cases of anti-tumor drug treatment in Nantong Tumor Hospital from January to December, 2023, and the efficacy of the trigger tool was evaluated. Results Through the preliminary preparation, 50 triggers were initially drafted. After two rounds of Delphi expert consultation, 48 trigger items were finally determined, including 25 laboratory indicators, 12 clinical symptoms, 9 antidotes, and 2 intervention measures. Among the 300 reviewed cases, all 48 trigger items had positive triggers, with an ADR detection rate of 67.33%(202/300), and the overall positive predictive value of the trigger tool was 54.01% (829/1535). Conclusions The ADR trigger tool for anti-tumor drug in elderly patients developed in this study is well-designed and verified to be effective,and can provide a reference for medical institutions to conduct active monitoring of anti-tumor drugs in elderly patients and improve clinical medication safety.

Key words: aged, trigger tool, Delphi method, antineoplastic drug, adverse drug reaction, active monitoring

中图分类号:

R 969.3

姚敏, 周海辉. 基于德尔菲法构建老年患者抗肿瘤药物不良反应监测触发工具[J]. 实用老年医学, 2026, 40(9): 906-912.

YAO Min, ZHOU Haihui. Construction of a trigger tool for monitoring adverse drug reactions of antitumor drugs in elderly patients based on the Delphi method[J]. Practical Geriatrics, 2026, 40(9): 906-912.

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