药物负担的动态变化导致老年人跌倒和再入院:朝着改善风险和管理成本的战略迈进
Rafia S Rasu1, Christy Xavier1, Nahid Rianon2
1University of North Texas Health Science Center at Fort Worth.
Journal of managed care & specialty pharmacy
|January 2, 2025
概括
药物负担指数 (DBI) 有助于预测药物不良事件 (ADEs),例如老年人中跌倒. 使用DBI指标可以提高健康计划的星级评级,并减少住院治疗.
科学领域:
- 老年学和制药科学 医学
- 医疗保健服务研究 医疗服务研究
- 临床药房 临床药房
背景情况:
- 由于生理变化,老年人容易受到药物不良事件 (ADEs) 的影响.
- 药物负担是ADEs的重要风险因素,包括跌倒,住院和死亡率.
- 健康计划的表现,特别是星级评级,受到与药物相关的结果的严重影响.
研究的目的:
- 突出药物负担指数 (DBI) 在评估老年人药物相关风险方面的重要性.
- 展示DBI如何用于预测和预防不良药物事件 (ADEs),如跌倒和重入医院.
- 探索DBI在改善健康计划绩效指标方面的潜力,包括医疗保险和医疗补助服务中心 (CMS) 星级评级.
主要方法:
- 使用药物负担指数 (DBI),衡量抗胆固醇和镇静剂药物负担.
- 对不良事件分析DBI大于0.1的平均差异的预测能力.
- 建议将DBI三角度量集成到电子病历中.
主要成果:
- 药物负担指数 (DBI) 与跌倒,头和平衡问题的风险增加密切相关.
- 平均DBI差异超过0.1显著预测不良事件,如跌倒和30天的医院再入院.
- 实施DBI指标提供了一条减少跌倒发生率和相关医疗保健利用的途径.
结论:
- 将DBI指标纳入医疗保健决策可以减轻ADEs,减少住院治疗,提高患者的生活质量.
- 使用DBI定制处方利用管理工具可以减少可避免的并发症和成本,解决药物使用中的社会不平等问题.
- 利用人工智能和机器学习等先进技术进行DBI分析,可以进一步完善风险预测并改善公平的医疗保健结果,积极影响CMS星级评级.
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