Montamat S C, Cusack B
Veterans Affairs Medical Center, Boise, Idaho.
Clin Geriatr Med. 1992 Feb;8(1):143-58.
Polypharmacy, the inappropriate use of multiple drug regimens, has a significant impact on the health of elderly individuals. Drug use increases with age, but suitability of therapy is sometimes difficult to define. In ambulatory and hospital care, there is some documentation of poor prescribing practices by physicians and drug misuse by patients. Sound data suggest that polypharmacy and drug misuse are highly prevalent in long-term care facilities. Psychotherapeutic agents are the most commonly misused drugs by physicians in this setting. Polypharmacy is associated with factors such as the number and severity of illnesses, hospitalization, number of physicians seen, number of pharmacies used, and possibly increased patient age. Methods to prevent polypharmacy and drug misuse have not been well studied. There is a need for intensive research to define effective methods to strengthen prescribing practice of physicians for elderly patients, to promote cooperation among health care personnel in ensuring optimal drug use by patients, and to enhance the role of patients as responsible partners in drug therapy. The authors are confident, however, that drug misuse and polypharmacy can be reduced in older persons by the use of current knowledge of risk factors associated with polypharmacy and by improved communication between the physician and patient.
多重用药，即不恰当地使用多种药物治疗方案，对老年人的健康有重大影响。药物使用量会随着年龄增长而增加，但治疗的适用性有时难以界定。在门诊和住院护理中，有一些关于医生开方不当和患者药物滥用的记录。可靠数据表明，多重用药和药物滥用在长期护理机构中极为普遍。在这种情况下，精神治疗药物是医生最常滥用的药物。多重用药与疾病的数量和严重程度、住院情况、看诊医生数量、使用的药房数量以及患者年龄可能增加等因素有关。预防多重用药和药物滥用的方法尚未得到充分研究。需要进行深入研究，以确定有效的方法来加强医生对老年患者的开方规范，促进医护人员之间的合作以确保患者合理用药，并增强患者在药物治疗中作为责任伙伴的作用。然而，作者相信，通过利用与多重用药相关的风险因素的现有知识以及改善医生与患者之间的沟通，可以减少老年人的药物滥用和多重用药情况。
