药剂师指导的硫基尿素抑制在老年人处方
Journal of the American Pharmacists Association : JAPhA
|March 21, 2025
概括
临床药剂师成功地减少了对低血糖的高风险的老年患者的硫基尿素使用. 这种干预有助于维持受控的血糖 (A1c) 水平,证明了对降低高风险糖尿病药物的安全方法.
科学领域:
- 老年医学 老年医学
- 临床药房 临床药房
- 药物经济学 药物经济学
背景情况:
- 硫类尿素在老年患者中具有显著的低血糖风险,尽管其成本低且持续使用.
- 对于老年人来说,建议个性化血糖目标 (A1c),为减少在控制良好的糖尿病中使用硫基尿素创造机会.
- 不适当的硫基尿素治疗导致的低血糖是老年人群中昂贵且可能致命的不良事件.
研究的目的:
- 通过实施临床药剂师主导的干预措施来降低低血糖的风险,重点是系统地降低老年患者的硫尿素处方.
- 评估药剂师驱动的抑郁症在管理护理环境中的有效性.
主要方法:
- 确定了年龄≥80岁,A1c控制 (≤6.5%) 和最近使用硫基尿素的患者作为抑郁症候选人.
- 进行了医疗数据审查,以评估硫氨酸urea discontinuation 的临床适当性.
- 致力于让医生根据患者数据,临床指南和处方理由考虑进行抑郁症.
主要成果:
- 89名患者被确定为停止使用硫基尿素的候选人.
- 药剂师的干预导致41% (n = 37) 确定的患者成功停止治疗.
- 干预后的平均A1c水平保持在推目标范围内.
结论:
- 药剂师主导的干预措施有效地促进了老年人服用高风险药物,如硫氨基酸.
- 系统的指导,药物专业知识和药剂师的协作支持有助于医生做出处方决定.
- 这种方法可以通过降低低血糖危险,同时保持血糖控制来提高患者的安全性.
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