在门诊提供潜在不合适的药物:不同测量方法的比较
Yves Eggli1, Patricia Halfon1, Minette-Joëlle Zeukeng2
1Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
Risk management and healthcare policy
|November 29, 2023
概括
在瑞士,可能不合适的药物 (PIM) 处方是常见的,特别是安眠药和抗焦虑药. 需要针对具有高PIM处方率的医生进行干预.
科学领域:
- 药物监督 药物监督 药物监督
- 医疗保健服务研究 医疗服务研究
- 老年医学 老年医学
背景情况:
- 可能不合适的药物 (PIMs) 对患者的安全构成风险,特别是在老年人中.
- 常规收集的数据为监测PIM处方模式提供了宝贵的资源.
- 识别和减少PIM使用对于改善医疗保健质量和患者结果至关重要.
研究的目的:
- 用例行收集的处方数据来比较测量PIM的不同方法.
- 为了确定瑞士PIM发行率和流行率.
- 确定与PIM相关的特定有问题的处方实践和药物类别.
主要方法:
- 在瑞士卫生维护组织 (2019-2020) 中,分析了大约9万名17岁以上的处方数据.
- 使用既定标准 (Beers,Priscus,Laroche,NORGEP,Prescrire) 和一个新的瑞士背景综合指标,对PIM计数进行比较.
- 医生对PIM分析的分层,包括处方开始和终止,以及按年龄组.
主要成果:
- 每个PIM测量方法都有独特的优缺点,支持开发一个综合指标.
- 对于睡眠药,抗焦虑药和NSAID药物,即使是长期使用,也观察到PIM处方的高率.
- 一个综合指标显示,在2020年,27%的64岁以上的个人至少接受了一次PIM,医生之间的处方差异很大.
结论:
- 在瑞士,PIM的处方非常普遍,主要是由于特定的药物类别,如安眠药和抗焦虑药.
- 在PIM处方方面,医生级别的显著变化需要针对高处方医生进行有针对性的干预.
- 调查结果强调需要改善PIM监测和有针对性的干预措施,以提高瑞士的药物安全.
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