处方和施用多药剂量之间的差异的纵向队列研究:对国家老年护理质量指标计划的影响
Nasir Wabe1, Rachel Urwin2, Karla Seaman2
1Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia nasir.wabe@mq.edu.au.
BMJ quality & safety
|July 16, 2024
概括
在老年护理中,多药房的比率大大不同,这取决于是否计入处方或服药药物. 这凸显了对标准化方法的需求,以准确测量老年人药物使用的情况.
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.
- 医疗信息学 医疗信息学
背景情况:
- 多药性是住宅老年护理设施 (RACF) 的关键质量指标.
- 目前对多药的定义和数据来源缺乏标准化,影响了监测和基准评估.
- 数据来源选择对多药房价格的影响需要调查.
研究的目的:
- 通过使用处方和服药数据来确定多药性率 (≥9种并发药物).
- 分析各种数据场景和回顾时期的多药房利率.
- 为了确定处方和施用多药之间的差异的预测因素.
主要方法:
- 一项纵向队列研究,涉及澳大利亚新南威尔士州5662名居民.
- 从2019年1月到2022年9月,每两周计算处方和服药的多药房费率.
- 使用不同数据类型 (药品,非药品,任何,常规) 和回顾期 (0,1,2,4周) 计算12个多药房费率.
主要成果:
- 多药房率差异很大,从33.9% (使用常规药物,没有回顾) 到63.5% (处方药/非药品,四周回顾).
- 根据回顾期,在处方和施用剂量之间观察到超过3.0%至10.0%的一致差异.
- 糖尿病居民的多药差异可能性超过两倍;痴呆症居民的可能性降低.
结论:
- 根据处方药与服药药物数据得出的多药房率之间存在显著的差异.
- 目前用于计算多种药物的指导可能会导致不一致的测量和报告.
- 建议对国家质量指标计划进行审查,以确保标准化的多药监测.
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