在养老院过度和不足使用质子抑制剂:一个多站点的纵向队列研究
Nasir Wabe1, Rachel Urwin1, Isabelle Meulenbroeks1
1Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Journal of the American Medical Directors Association
|December 6, 2024
概括
不适当使用质子抑制剂 (PPI) 在养老院很常见,有27.1%的用户过度使用PPI,38.5%的长期出血风险增加的药物使用者没有接受胃保护. 需要进行干预,以优化PPI处方.
科学领域:
- 老年医学 老年医学
- 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:
- 质子抑制剂 (PPI) 能够控制多余的胃酸,并防止增加出血风险的药物 (BRID).
- 评估老年护理机构的PPI使用模式对于优化患者护理至关重要.
- 不适当的处方会导致不良事件和增加医疗保健成本.
研究的目的:
- 为了确定在养老院居民中使用潜在不适当的质子抑制剂 (PPI) 的流行率.
- 确定与不适当的PPI使用相关的因素,包括过度使用和过少使用.
- 为改善老年护理中PPI处方实践的干预提供信息.
主要方法:
- 一项纵向队列研究分析了34个养老院的6439名65岁以上居民8年的电子数据.
- 不适当的过度使用被定义为连续使用PPI (>12周) 没有长期使用BRID.
- 不适当的不足使用被定义为长期使用BRID而没有同时使用PPI来保护胃.
主要成果:
- 54%的居民接受了PPI,其中83.6%使用超过12周.
- 不适当的PPI过度使用的流行率为27.1%.
- 与提供者B相比,提供者A居民的PPI过度使用明显高 (OR4.08).
- 38.5%的长期BRID使用者经历过PPI使用不足.
结论:
- 显著比例的养老院居民经历了不适当的PPI使用,通过过度使用或使用不足.
- 有针对性的干预措施,包括药物审查和停止处方,对于改善PPI处方至关重要.
- 解决PPI处方模式可以提高老年护理机构的患者安全和药物疗效.
相关概念视频
Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors
357
Peptic ulcers, often induced by H. pylori infections or NSAID usage, arise from disruptions in the delicate balance of gastric acid production. Peptic ulcers stem from heightened gastric acid levels due to H. pylori infections or NSAID use. The protective mucus layer diminishes in the presence of these factors, allowing gastric acid to erode the stomach lining and form ulcers.
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
357
Peptic Ulcer Disease IV: Management
72
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
72
Acid Suppressive Drugs for Peptic Ulcer Disease: Histamine H2-Receptor Antagonists
407
Histamine H2 receptors, which are intricately located on the basolateral membrane of parietal cells, play a crucial role in modulating gastric acid secretion. When released from enterochromaffin-like cells, histamine engages H2 receptors, initiating the cyclic AMP (cAMP) pathway. In this pathway, adenylyl cyclase converts ATP into cAMP, elevating intracellular cAMP levels. The activation of protein kinase A follows, stimulating the proton pump. This stimulation prompts the secretion of hydrogen...
407
Peptic Ulcer Disease V: Surgical Management and Nursing Care
228
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
228
Pathophysiology of Peptic Ulcer Disease: Mucosal Defense Factors
356
Peptic ulcer disease, commonly called PUD, represents a multifaceted condition characterized by disruptions in the lining of the gastrointestinal (GI) tract. Central to the protection of the gastrointestinal lining is the mucosal-bicarbonate barrier. This physiological defense mechanism is a formidable shield against the corrosive effects of gastric acid and pepsin secretion in the stomach. Its role is pivotal in maintaining the structural integrity of the stomach's inner lining.
356
Pneumonia V: Nursing management and Prevention
1.9K
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
1.9K


