退院後の薬剤関連緊急診療の発生率,原因,予防可能性:韓国の単一三級病院の研究
Hyein Kang1, Soyoung Park2, Kyu-Nam Heo2
1College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea; Infection Control Center, Seoul National University Hospital, Seoul, Republic of Korea.
Journal of the American Medical Directors Association
|August 31, 2025
まとめ
退院後,約20人の高齢者のうち1人が緊急治療室を訪れ,その3分の1が薬剤関連です. 薬剤による緊急治療室訪問と再入院の40%以上は予防可能で 介入の必要性を強調しています
科学分野:
- 高齢者医療
- 臨床薬局
- 患者の安全
背景:
- 高齢者における薬物関連再入院は重要な医療問題です.
- これらの出来事を特定し防止するための標準化された方法は限られている.
- 高齢の患者は,退院後の薬物の副作用に特に脆弱です.
研究 の 目的:
- 退院後30日以内に,緊急再入院を含む,医薬品関連の緊急診療の発生率を調査する.
- 高齢者のED訪問の原因と予防可能性を特定する.
- 退院後の薬物有害事象を減らすための標的の介入を促す.
主な方法:
- 横断的な研究デザインが採用された.
- 65歳以上の非癌診断の患者で,韓国の三級病院から退院した (2018年1月〜2019年12月) 患者も対象となった.
- 2人の薬剤師が電子医療記録を独立して検討し,薬物関連ED訪問と再入院の関連性と予防可能性を特定し評価しました.
主要な成果:
- 退院した19106人の患者のうち,6. 7%が30日以内にED訪問を受けた.
- 治療関連の原因は33.4%で,出血,心血管疾患,転倒が最も一般的でした.
- 薬剤関連ED訪問のほぼ半分 (43. 4%) と再入院の37. 0%は予防できると見なされた.
結論:
- 高齢の患者の多くは 退院後のED訪問や再入院を経験しています
- これらのイベントの多くが予防可能であり,介入の可能性を示しています.
- 薬剤によるER訪問を軽減し,高齢者の患者の安全性を改善するために,標的型戦略が必要です.
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