在急性住院的老年医疗患者中进行跨专业药物审查的有效性:随机对照试验
Louise Westberg Strejby Christensen1,2,3, Helle Gybel Juul-Larsen1, Rikke Lundsgaard Nielsen1
1Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark.
British journal of clinical pharmacology
|December 5, 2025
概括
一项结构化药物审查显示,在老年人中改善药物适当性的趋势,但没有达到统计学意义. 降低处方成为提高药物安全性的关键策略.
科学领域:
- 老年病的医生 老年病的医生
- 临床药房 临床药房
- 内部医学 内部医学
背景情况:
- 不适当的处方是老年人的一个重要问题,特别是在急诊室 (ED) 设置中.
- 药物评估对于优化药物治疗和预防老年患者不良药物事件至关重要.
研究的目的:
- 评估结构化,以患者为中心,跨专业药物审查在减少ED中老年人中不适当处方的有效性.
- 将接受药物审查的干预组 (IG) 与接受标准护理的控制组 (CG) 进行比较.
主要方法:
- 一项随机对照试验涉及151名入院ED的老年人 (≥65岁).
- 参与者被随机分配到接受临床药剂师和老年医生药物审查的干预组或接受标准护理的对照组.
- 主要结局是8周内药物适用性指数 (MAI) 评分的变化,次要结局包括使用不足的变化和潜在不适合药物的数量.
主要成果:
- 干预组的MAI得分平均提高了2.2分,而对照组的1.2分 (P=0.3),表明差异不大.
- 不恰当处方的常见原因包括缺乏指示,错误的剂量和不适当的持续时间.
- 总共有295种药物被处方,其中IG为21.3%,CG为15.9%.
结论:
- 结构化药物审查改善了MAI得分,但与标准护理相比,这种差异在统计学上并不显著.
- 停止处方被强调为提高老年人药物适当性的重要策略.
- 进一步研究抑郁症的干预措施是有必要的,以改善这种人群的药物管理.
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