在多药性老年人处方的共同决策干预措施:一个范围审查
Soroush Fariman1, Arman Arabshomali2, Darshna Goordeen3
1Division of Pharmaceutical Outcomes and Policy, University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA.
Journal of the American Geriatrics Society
|August 29, 2025
概括
在老年人处方中,共享决策 (SDM) 在实施和测量方面表现出差异性. 虽然与改善的满意度有关,但其对患者健康结果的影响仍然不确定.
科学领域:
- 老年医学
- 药理学
- 医疗服务研究
背景情况:
- 分享决策 (SDM) 对于减缓处方至关重要,但其融入干预和对患者结果的影响还未得到充分研究.
- 有多种药物治疗的老年人往往需要缓解处方干预,强调需要了解SDM的作用.
研究的目的:
- 进行对研究的范围审查,以检查共享决策 (SDM) 的干预措施,以减少老年人使用多种药物.
- 分类这些干预措施的核心功能和形式,并分析它们的测量结果,包括与SDM相关的结果.
主要方法:
- 在多个数据库 (PubMed/MEDLINE,Embase,Scopus,PsycInfo) 进行了全面的范围审查,直到2023年9月.
- 包含的研究重点是针对多种药物治疗的老年人的SDM干预措施.
- 数据由两个独立的审稿人选和抽象,随后进行代叙述合成.
主要成果:
- 包含12种不同的干预措施的14项研究符合纳入标准,主要是由初级保健医生或药剂师领导的门诊研究.
- 常见的干预功能包括患者/药物识别,SDM,决策支持和护理协调.
- 大多数研究报告了与药物使用和抑郁症行为的积极关联,尽管只有三项明确测量了SDM的发生.
结论:
- 处方干预措施在SDM整合和经验测量方面表现出显著的变化.
- 虽然SDM与改善护理的满意度和过程有关,但对其对患者行为和健康结果的影响的证据是不确定的.
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