在老年人中停止处方,并使用多种药物
Anna Hung1,2,3,4, Yoon Hie Kim5,4, Juliessa M Pavon5,6
1Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA anna.hung@duke.edu.
概括
对老年人进行多种药物治疗的处方干预措施非常有前途,超过一半的治疗效果优于常规护理. 这些干预措施通常涉及药物审查,共享决策和以患者为中心的护理.
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.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 多药在老年人中很普遍,导致不良药物事件,功能衰退和医疗保健利用率增加.
- 降低处方 (停止使用药物) 的障碍很大,需要有针对性的干预措施.
- 降低处方干预的目的是减少药物负担,改善老年人群的治疗结果.
研究的目的:
- 审查老年人多药性抑郁症干预措施的组成部分.
- 总结这些干预措施测试的随机对照试验 (RCT) 的发现.
- 报告正在进行的试验,指导方针和资源,以促进抑郁症.
主要方法:
- 发表的RCT和正在进行的试验的叙述性审查.
- 干预组件的分析,包括药物审查,共享决策,患者优先事项,专业培训,患者教育和家庭参与.
- 综合结果,比较干预措施与常规护理.
主要成果:
- 干预措施在组件和交付设置 (主要是初级保健) 中表现出显著的异质性.
- 超过一半的测试干预措施在至少一个主要结果中表现出优于通常护理的优势.
- 大多数研究评估了干预措施在12个月或更短的时间内的有效性.
结论:
- 降低处方干预措施,特别是以患者为中心的药物评价,可以在多药的老年人中有效.
- 需要进一步的研究来优化干预设计和评估长期有效性.
- 干预措施的多样性凸显了针对老年人药物管理的量身定制方法的需要.
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