对老年住院患者的药物优化协议有效性:一项随机临床试验
Kenya Ie1,2, Masanori Hirose1, Tsubasa Sakai1,2
1Department of General Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan.
针对多种药物治疗的老年住院患者的多学科药物优化干预措施并没有减少医院访问或再住院. 然而,它有效地减少了处方药的数量,而没有增加不良事件.
科学领域:
- 老年病的医生 老年病的医生
- 内部医学 内部医学
- 临床药房 临床药房
背景情况:
- 多药在老年住院患者中普遍存在,缺乏关于有效干预措施的共识.
- 在老年患者中管理多种药物会带来重大的临床挑战.
研究的目的:
- 评估一个多学科的基于团队的药物优化策略.
- 评估对多药性老年人的生存,非预定的住院和再住院的影响.
主要方法:
- 开放式随机临床试验,涉及442名老年住院患者 (≥65岁) 服用≥5种药物.
- 干预组接受了多学科团队的药物审查 (STOPP/START标准) 和优化建议.
- 对照组接受了通常的护理;结果在12个月后进行评估.
主要成果:
- 干预组在出院,6个月和12个月时显示出潜在不合适药物的显著减少.
- 在组之间 (49.3%对51.5%) 的初级综合结果 (死亡,非预定的访问,再住院) 中没有发现显著差异.
- 干预和通常护理组之间的不良事件是相似的.
结论:
- 多学科药物优化并没有减少老年多药性住院患者的死亡率,非预定的访问或再住院.
- 干预成功地减少了处方药的数量,但没有对临床结果产生负面影响.
- 进一步的研究可能会探索为这个人群量身定制的抑郁症描述策略.
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