多药在老年多病症患者中:患者和全科医生报告的药物之间的协议在cRCT试点中观察到
Lena Schäfer1, Michael Paulitsch1, Maria Hanf1
1Institute of General Practice, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
International journal of environmental research and public health
|October 26, 2024
概括
多药房增加了患者和全科医生之间的药物报告差异. 一项试点研究发现,以纸张为基础的患者组合没有改善协议,并揭示了报告药物的显著差异.
科学领域:
- 老年学是一门学科.
- 临床药房 临床药房
- 医疗信息学 医疗信息学
背景情况:
- 多药性,定义为使用五种或更多药物,在老年人中很常见,并增加了药物不一致的风险.
- 患者和全科医生 (GP) 药物报告之间的差异可能导致不良健康结果.
- 一个基于纸质的患者投资组合干预措施进行了试点测试,以评估其对药物报告协议的影响.
研究的目的:
- 为了探索患者和GP报告的药物之间的协议在老年人与多药.
- 评估纸质患者组合对药物报告准确性的影响.
- 确定导致药物报告不一致的因素.
主要方法:
- 一个试点集群随机对照试验 (cRCT) 涉及68名65岁以上的多病症和多药症患者.
- 在基线和六个月的患者和GP报告之间对药物名称和强度的一致性评估.
- 对活性药物成分 (API) 和解剖治疗化学物质 (ATC) 组进行分析,以了解差异原因.
主要成果:
- 患者和GP药物报告之间的基线一致性是中度的 (72.1%IG,73.9%CG),当药物的强度被包括在内 (66.7%IG,60.0%CG) 时会下降.
- 干预组 (IG) 的同意率在六个月后显著下降了5.4%.
- 对B,C和HATC组观察到高度一致性,而N,R和Z显示出最低的一致性,这表明报告的API和ATC组存在重大差异.
结论:
- 在这项试点研究中,纸质患者组合并没有改善药物报告协议.
- 患者和GP药物报告之间存在重大差异,特别是关于药物的强度和特定的API/ATC组.
- 需要进一步的研究来制定有效的策略,以减少多药患者的药物差异.
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