以人为中心与老年患者常规护理的有效性:多中心随机对照试验的发现
C Rovira1,2,3,4, M Casanovas1, E Vizcaino1
1Primary and Community Care Management of Central Catalonia, Institut Català de la Salut, Sant Fruitós de Bages, Spain.
Journal of pharmaceutical policy and practice
|January 22, 2026
概括
协作药物管理 (CMM) 有效地减少了药物和与药物相关的处方在多种药物治疗的老年人中. 这种以个人为中心的护理方法优化了药物治疗计划,并在12个月内改善了药物坚持.
科学领域:
- 老年学是指老年学的学科.
- 初级医疗保健医学 一级医疗保健医学
- 临床药房 临床药房
背景情况:
- 以人为中心的护理 (PCC) 涉及多学科的团队与患者的偏好和目标调整护理.
- 在初级保健中PCC的证据有限,需要进一步评估.
- 多种药物治疗的老年人往往需要优化药物治疗计划.
研究的目的:
- 评估协作药物管理 (CMM) 方法的有效性.
- 将CMM与通常的护理进行比较,以优化多种药物治疗的老年人药物治疗.
- 评估CMM对药物负担,与药物相关的处方和治疗计划变化的影响.
主要方法:
- 一个随机的,开放的,多中心的临床试验,涉及208名多种药物治疗的老年人 (≥75岁,≥8种慢性药物).
- 干预组接受了CMM与结构化药物审查和以患者为中心的护理计划.
- 对照组接受了通常的护理,在6个月和12个月后进行了随访.
主要成果:
- 与常规护理相比,CMM组的药物数量 (1.8对0.3增加) 和与药物相关的处方 (2.9对0.2增加) 显著减少 (p=0.004).
- CMM导致了更多的药物治疗计划变化 (4.3比2.6,p=0.004) 和12个月后变化更持久 (3.8比2.2,p<0.001).
- 两组之间没有观察到医院入院或与药物相关的安全事件的显著差异.
结论:
- 以人为中心的护理模式,特别是协作药物管理,有效地优化了多种药物治疗的老年人的药物使用.
- 在这种人群中,CMM在减少药物负担和改善药物治疗管理方面显示出显著的好处.
- 进一步的研究应该探索CMM在初级保健机构的长期结果和成本效益.
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