通过多重处方优化多药房的临床结果:一项纵向研究.
1Center for Appropriate Medication Use, Sheba Medical Center, Ramat Gan, Israel.
Frontiers in medicine
|May 15, 2024
概括
减少老年人的药物数量 (多药) 改善了他们的生活质量和认知功能. 越多的药物被取消处方,患者结果的改善就越大.
科学领域:
- 老年学是一门学科.
- 临床药房 临床药房
- 公共卫生 公共卫生
背景情况:
- 多药在老年人中很普遍,增加药物不良事件的风险和降低生活质量.
- 系统的药物审查和取消处方对于优化老年人群的医疗保健至关重要.
研究的目的:
- 评估多处方药 (PDP) 对老年人生活质量 (QoL) 和临床结果的影响.
- 为了确定药物停止处方的程度是否与QoL和临床结果的改善有关.
主要方法:
- 一项前性的纵向队列研究,涉及307名居住在社区的老年人 (65岁以上),至少服用六种处方药.
- 使用加芬克尔算法提出了多处方建议,参与者被跟踪了3-10年.
- 参与者被分为两组:那些停止了50%以上的药物 (PDP组) 和那些停止了50%以下 (非响应者,NR) 的参与者.
主要成果:
- 与NR组 (2.2) 相比,PDP组从处方中取消了更多药物 (6.7).
- 两组之间在3年生存率或住院病例方面没有发现显著差异.
- 在PDP组,功能状态,认知功能和对干预的整体满意度显著改善.
结论:
- 在老年人中,多重解处方在临床结果和生活质量方面产生了显著的好处,而不会对生存率或住院率产生负面影响.
- 患者结局的改善程度与药物停止处方的程度直接相关.
- 像加芬克尔算法这样的取消处方策略的广泛应用可能会导致数百万人的质量质量大幅改善,这对患者和医疗保健经济学来说都是双赢的.
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