在社区居住的老年人处方:系统性审查和元分析
Amy M Linsky1,2,3, Aneesa Motala4,5, Marika Booth4
1Center for Health Optimization and Implementation Research, VA Boston Healthcare System, Boston, Massachusetts.
JAMA network open
|May 8, 2025
概括
抑郁的干预措施显示了适度的证据,可以减少老年人服用药物和潜在不合适药物 (PIM) 的数量. 虽然个体减少很小,但由于高的多药率,人口层面的影响可能很大.
科学领域:
- 老年学是指老年学的学科.
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 多药和潜在不合适的药物 (PIMs) 在社区居住的老年人中普遍存在,增加了药物不良事件的风险.
- 处方干预措施旨在通过减少药物负担来减轻这些风险.
- 在门诊环境中抑郁症的有效性需要进一步调查.
研究的目的:
- 评估抑郁症治疗干预与社区老年人减少药物计数和PIM的相关性.
- 综合来自随机试验的关于抑郁症有效性的证据.
主要方法:
- 2019年1月至2024年7月在PubMed和Cochrane图书馆发表的英语研究的系统审查和元分析.
- 纳入标准:仅或主要涉及抑郁症,社区成年人,多站点,随机试验设计.
- 分析使用随机效应模型;根据PRISMA标准报告.
主要成果:
- 对8项研究的综合分析发现,处方药物的平均差异为-0.14 (95% CI, -0.27至-0.01).
- 对6项研究的综合分析显示,至少1个PIM (OR,0.92;95% CI,0.74至1.14) 处方的人数比例没有显著减少.
结论:
- 抑郁症干预与老年人降低药物和PIM数量有关,有中度确定性的证据.
- 个体水平的药物减少很小,但人口水平的影响可能很大.
- 进一步研究优化抑郁症的策略是有必要的.
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