コミュニティに住む高齢者に対する不適切な薬の処方
S M Willcox1, D U Himmelstein, S Woolhandler
1Victorian Health Department, Melbourne, Australia.
JAMA
|July 27, 1994
まとめ
高齢のアメリカ人のほぼ4分の1は不適切な薬を服用しており,リスクが増加しています. 高齢者向けの処方箋の改善には,より広範な取り組みが必要である.
科学分野:
- ゲリアトリクス ゲリアトリクス
- 薬理学 薬理学とは
- 公衆衛生は公衆衛生である.
背景:
- 不適切な処方薬は,高齢者の大きな懸念事項です.
- コミュニティに住む高齢者は,薬物による有害事象に特に脆弱です.
- 既存の戦略は,主に制度化された高齢者集団に焦点を当てている.
研究 の 目的:
- 65歳以上のコミュニティに住むアメリカ人の間で不適切な薬の処方箋の有病率を決定する.
- この集団に不適切に処方されることが多い特定の薬物を特定するために.
主な方法:
- 1987年の全国医療支出調査のデータを用いた横断調査.
- 分析には6171人の高齢者が含まれており,国の代表性を確保するための重み付けが行われました.
- 老年医学専門家によって開発された明示的な基準を用いて,潜在的に不適切な薬剤20種を特定しました.
主要な成果:
- 高齢者の23.5% (6.6400万人) は,潜在的に不適切な20の薬物のうち少なくとも1つを受け取った.
- よく処方される不適切な薬には,ディピリダモール,プロプキシフェン,アミトリプチリンが含まれていました.
- 論争の的だった心臓血管疾患薬を含むと,発生率は32% (9,040万) に上昇した.
結論:
- 医師は,コミュニティに住む高齢者のかなりの部分に,潜在的に不適切な薬を処方しています.
- この慣行により,高齢者は認知障害や鎮静剤などの副作用のリスクにさらされます.
- 介護老人ホームに焦点を当てたイニシアチブを超えて,より広範な教育と規制戦略が必要である.
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