在欧洲的老年家庭护理患者中,潜在的不适当的药物使用
Daniela Fialová1, Eva Topinková, Giovanni Gambassi
1Department of Geriatrics and Gerontology, 1st Medical Faculty, Charles University, Prague, Czech Republic. fickova@faf.cuni.cz
JAMA
|March 17, 2005
概括
潜在不适当的药物使用影响了19.8%的欧洲老年家庭护理患者,区域差异很大. 经济状况不佳,多药制药和抑郁症会增加风险,而年龄较大和单身生活会降低风险.
科学领域:
- 老年人药理学 老年人药理学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 潜在不合适的药物 (PIM) 使用标准是在美国建立的,用于老年人风险识别.
- 欧洲关于PIM患病率的数据有限,小型研究缺乏概括性.
研究的目的:
- 确定欧洲国家老年家庭护理患者中PIM使用的流行率.
- 在这个人口群体中确定与PIM使用相关的因素.
主要方法:
- 一项回顾性横截面研究涉及来自8个欧洲国家的2707名老年家庭护理患者.
- 数据采集使用家庭护理工具的最低数据集.
- 使用Beers和McLeod标准评估了患病率;通过后勤回归确定了相关因素.
主要成果:
- 总体而言,19.8%的患者使用了至少一个PIM.
- 观察到显著的差异:捷克共和国的41.1%,而西欧的平均水平为15.8%.
- 使用PIM与经济状况不佳,多药,抗焦虑药的使用和抑郁症有关. 老年和独自生活是保护因素.
结论:
- 在PIM使用的实质性地理差异表明监管,临床和社会经济因素的影响.
- 财务资源和患者的特征会影响PIM的处方.
- 需要有针对性的教育策略和法规,以提高欧洲老年人处方质量.
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