使用老年人处方背景改善住院老年人中与剂量相关的不良药物事件
Bryanna De Lima1, Mitchell Nohner2, Kathleen Drago1
1Division of General Internal Medicine and Geriatrics, Oregon Health and Science University, Portland, Oregon, USA.
Journal of the American Geriatrics Society
|January 19, 2024
概括
老年处方环境 (GPC) 在老年人中显著减少了不良药物事件 (ADEs). 这种干预措施降低了与剂量相关的ADEs,改善了住院期间的患者安全.
科学领域:
- 老年人药理学 老年人药理学
- 患者安全 患者安全
- 医疗保健服务研究 医疗服务研究
背景情况:
- 对住院的老年人来说,药物不良事件 (ADEs) 是一个重大问题.
- 一个老年人处方背景 (GPC) 已开发,以优化药物剂量为这一群体.
- 在本研究之前,GPC对ADE率的影响仍未得到量化.
研究的目的:
- 评估老年处方环境 (GPC) 在减少ADEs方面的有效性.
- 在GPC实施之前和之后,比较老年人中的ADE率.
主要方法:
- 利用ICD-10代码和图表审查来识别10种常见药物的剂量相关的ADEs.
- 通过比较使用双项测试的ADE比例和通过Poisson测试每1000个患者日的率.
- 通过使用费舍尔精确测试,分析了危害类别的变化.
主要成果:
- 与剂量相关的ADEs的入院比例显著下降,从GPC后的0.0082降至0.0037 (p=0.04).
- 每1000个患者日中剂量相关的不良事件的发生率从2.5降至1.1 (p=0.001).
- 在ADE危害类别 (p=0.30) 中没有观察到显著变化.
结论:
- 老年人处方背景 (GPC) 与剂量相关的ADE显著减少有关.
- 这些发现支持GPC作为改善住院老年人药物安全的有效工具.
- 该研究的重点是通过ICD-10代码识别的特定药物.
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