对于有跌倒风险的老年退伍军人来说,取消电子案例审查:对药物负担和跌倒的影响
Juliessa M Pavon1,2,3, Spencer Davidson2, Richard Sloane1,2,3
1Department of Medicine/Division of Geriatrics, Duke University, Durham, North Carolina, USA.
Journal of the American Geriatrics Society
|November 9, 2023
概括
FAME计划减少了老年人的药物负担,降低了增加药物负担的几率. 这项试点研究表明,抑郁症可以降低高风险老年人的跌倒风险.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 患者安全 患者安全
背景情况:
- 跌倒是老年人的主要安全问题,通常与药物有关.
- 跌倒风险增加药物 (FRIDs) 对老年人的不良事件有显著的贡献.
- 减少FRID的使用是减轻跌倒风险的潜在策略.
研究的目的:
- 评估FAME计划对FRID负担的影响.
- 评估FAME计划对高风险退伍军人的秋季相关急性访问的影响.
- 用修改后的药物负担指数 (DBI) 来确定药物负担的1年变化.
主要方法:
- 在FAME项目中,跨学科团队审查了65岁以上的高跌倒风险退伍军人的病例.
- 处方建议被转发给处方者,并通过电话跟踪实施.
- 修改后的药物负担指数 (DBI) 用于计算一年内FRID负担的变化.
主要成果:
- 与对照组相比,FAME干预组增加DBI的几率明显较低 (OR 0.37).
- 虽然主要结果 (修改后的DBI变化) 在不同组之间没有达到统计学意义,但这种趋势有利于干预.
- 与跌倒相关的急性事件发生在干预组的6.3%,对照组的11.0% (p=0.10).
结论:
- 在高风险的老年人中,FAME计划有效地降低了增加FRID负担的可能性.
- 电子案例审查和电话咨询的综合方法对减少与毒品有关的跌倒有很大的希望.
- 这项试点研究支持压抑处方干预措施的潜力,以提高药物安全性和减少老年人跌倒的可能性.
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