药物治疗管理计划对老年人潜在不适当使用药物的影响:系统性审查
Preeyanka Rao1,2, Anna Hung1,3,4
1Duke-Margolis Center for Health Policy, Duke University, Durham, NC.
Journal of managed care & specialty pharmacy
|December 28, 2023
概括
药物治疗管理 (MTM) 计划在减少老年人潜在不适合使用的药物 (PIM) 方面表现有前途. 然而,需要更严格的研究来证实这些好处,并建立一致的结果指标.
科学领域:
- 老年人药理学 老年人药理学
- 医疗保健服务研究 医疗服务研究
- 系统审查是系统的审查.
背景情况:
- 潜在不合适的药物 (PIMs) 对老年人构成重大风险和成本.
- 在这个人群中,PIM与高的不良事件率和有限的已证明的益处有关.
- 药物治疗管理 (MTM) 计划提供了减轻PIM使用的潜在解决方案.
研究的目的:
- 系统地审查有关MTM计划对老年人PIM使用的影响的现有文献.
- 综合评估MTM干预措施以减少PIM的研究结果.
主要方法:
- 使用MEDLINE (PubMed) 进行了一项系统的文献审查.
- 纳入标准包括特定的医疗保险人群,美国研究,MTM计划,PIM作为主要结果的使用,RCT或观察设计,以及英语.
- 在选了221篇文章后,有7项研究符合所有纳入标准.
主要成果:
- 其中七项研究中的五项表明,在MTM计划后,PIM使用减少.
- 研究环境非常多样,包括学术医疗中心,社区药房和远程医疗提供者.
- 患者人口统计主要为女性 (61-71%) 和白人 (81-94%),平均年龄为73-78岁.
结论:
- 在老年人中,MTM计划似乎对减少PIM使用产生了积极的影响.
- 局限性包括研究设计的变化,不一致的结果指标和短的随访时间.
- 未来的研究应该侧重于混调整,比较组,长期结果和标准化措施.
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