在初级保健中识别药物不良反应的方法:系统性审查
Vera Logan1, David Hughes2, Adam Turner2
1Department of Nursing, Faculty of Health and Social Studies, University of South Bohemia, Ceske Budejovice, Czechia.
PloS one
|February 4, 2025
概括
在老年人中发现药物不良反应是很困难的. 这次审查发现,虽然一些方法显示出希望,但需要更多的研究来优化患者安全策略.
科学领域:
- 老年医学 老年医学
- 药物监督 药物监督 药物监督
- 初级保健研究研究初级保健研究
背景情况:
- 在老年人中实时识别药物不良反应 (ADRs),在初级保健中多种药物治疗的个体是具有挑战性的.
- 当前的识别策略往往缺乏系统的方法.
- 本次审查重点是评估识别和管理ADR的方法.
研究的目的:
- 系统地审查和评估可复制的工具和方法,以识别和解决药物不良反应 (ADRs).
- 评估随机对照试验 (RCT) 中用于初级保健中ADR识别和解决的策略.
主要方法:
- 在多个数据库 (Medline,CINAHL,Scopus,Web of Science,Cochrane) 中进行系统搜索.
- 包括集中在初级保健患者的ADR识别或解决的RCT.
- 独立选,数据提取,以及由两名审稿人进行偏差风险评估.
主要成果:
- 包括49项研究中的6项RCT,所有这些研究都使用与药物相关的症状列表来识别ADR.
- 问卷增加了ADR报告率;结合问卷和咨询减少了健康问题.
- 多学科合作显示出提高患者安全的潜力,但研究的局限性 (解盲,低于最佳的保留) 产生了模两可的结果.
结论:
- 初级保健需要具有决策支持的可适应,可扩展的工具,以识别和减轻老年人与药物相关的危害.
- 需要进行更多的多中心试验,以探索ADR识别工具和最佳交付方法的有效性.
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