闭环药物安全管理减少了老年风湿性和免疫性疾病患者不适当的药物
Dan Chen1, Jing Feng1, Zhihui Chen2
1Department of Clinical Pharmacy (Pharmacy Department), West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Medicine
|January 7, 2026
概括
药物安全性闭环管理显著减少了老年风湿病患者的潜在不合适药物 (PIM) 和药物不良反应 (ADR). 这种干预措施还改善了药物适当性,药物坚持性和患者满意度.
科学领域:
- 老年医学 老年医学
- 临床药房 临床药房
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
背景情况:
- 患有风湿性和免疫性疾病的老年患者经常面临复杂的药物治疗方案.
- 这些患者面临潜在不合适药物 (PIM) 的高风险,导致药物不良反应 (ADR),不良坚持和满意度下降.
- 目前的药物管理模式往往不足以满足这一群体的需求.
研究的目的:
- 评估药物安全闭环管理在患有风湿性和免疫性疾病的老年患者中的有效性.
- 评估这项干预措施对PIM发生率,药物适当性,副作用,坚持和患者满意度的影响.
主要方法:
- 一个单一中心的回顾性受控研究,涉及100名老年住院患者.
- 患者被分为一个干预组 (n=50) 接受药物安全闭环管理和一个控制组 (n=50).
- 这项干预涉及临床药剂师,数字风险警报和全过程药物跟踪.
主要成果:
- 干预组显示PIM发病率显著下降 (16%与对照组58%相比,P<.05).
- 干预组的药物适当性增加到86%,而对照组的44% (P<.05).
- 副作用发生率下降 (8%vs. 24%对照组,P<.05),而药物坚持 (90%) 和患者满意度 (96%) 显著改善.
结论:
- 药物安全闭环管理,整合IT和多学科合作,大大提高了药物安全性和适当性.
- 这种方法有效地减少了ADRs,并改善了风湿和免疫疾病的老年患者的坚持和患者满意度.
- 这些发现支持了这种管理策略的临床价值和更广泛实施的潜力.
更多相关视频
06:59A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
31.1K
04:50Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
Published on: May 16, 2025
806
相关概念视频
01:15Drug Dosing: Geriatric Patients
219
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
219
01:21Rheumatic Heart Disease III: Medical Management
278
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
278
01:20Rheumatic Heart Disease IV: Nursing Management
262
AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
262
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
194
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
194
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
232
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
232
01:00Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
227
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
227