系统概述的累积更新,评估针对多药的干预措施
Michelle S Keller1,2,3, Nabeel Qureshi1,4, Allison M Mays5
1Division of General Internal Medicine, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
JAMA network open
|January 10, 2024
概括
多药剂干预措施对改善关键临床结果的证据有限. 需要更多的研究来确定有效的策略和针对多药店管理的目标人群.
科学领域:
- 老年学是指老年学的学科.
- 临床药房 临床药房
- 医疗保健服务研究 医疗服务研究
背景情况:
- 多药与不良结果有关,包括死亡率,跌倒,住院和认知能力下降.
- 越来越多地关注多药干预措施,需要更新系统概述.
研究的目的:
- 系统地评估和综合来自多次系统性审查对处理多药学的干预措施的证据.
主要方法:
- 对从2017年1月到2022年10月出版的系统评价进行了全面的文献搜索,并补充了之前的概述.
- 系统性审查包括不论研究设计,设置或结果.
- 证据被分类为与药物相关的过程结果,临床/功能结果,医疗保健使用/经济结果以及干预的可接受性.
主要成果:
- 包括14个系统性审查,代表了179个独特的研究.
- 干预措施显示,潜在不合适的药物 (PIM) 和药物负担有所减少,但死亡率和跌倒等临床结果的证据主要为零或低质量.
- 在一些强度更高的审查中观察到住院减少,但对医疗保健使用结果的总体证据有限.
结论:
- 这份综述发现,支持多药性干预措施改善主要临床和医疗保健利用结果的证据有限.
- 需要进一步的研究来确定最有效的干预措施,并确定从多药店管理策略中获益最多的特定人群.
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