Finkers F, Maring J G, Boersma F, Taxis K
Department of Pharmacotherapy and Pharmaceutical Care, GUIDE, University of Groningen, Groningen, The Netherlands.
J Clin Pharm Ther. 2007 Oct;32(5):469-76. doi: 10.1111/j.1365-2710.2007.00849.x.
Little is known about the extent of drug-related problems of polypharmacy patients in Dutch nursing homes.
We investigated the feasibility of teams of hospital pharmacists and nursing home physicians carrying out medication reviews. We aimed to identify the number and nature of drug-related problems of nursing home patients receiving more than nine drugs (polypharmacy).
The study was carried out in five Dutch nursing homes (n = 742 beds) between October 2005 and May 2006. Ninety-one polypharmacy patients, (average age 80 years) were included. A medication review was carried out by teams consisting of one hospital pharmacist and the patient's nursing home physician with a follow-up meeting of the same team 6 weeks later.
A total of 323 drug-related problems were identified (mean of 3.5 problems per patient). Sixty-two per cent of problems, in 87% of patients, were classified as 'unclear or not confirmed indication or need for review' of the prescribed drug. By the time of the follow-up, a mean of 1.7 (n = 159) problems per patient had been solved and the number of drugs per patient had decreased significantly from 13.5 to 12.7 (P < 0.0001).
The majority of patients had at least one drug prescribed for which the indication was unknown. The intervention was accompanied by a significant decrease in the number of drugs per patient, but half of the drug-related problems remained unsolved.
对于荷兰养老院中使用多种药物的患者所面临的与药物相关问题的程度，人们了解甚少。
我们调查了医院药剂师和养老院医生团队开展药物评估的可行性。我们旨在确定接受九种以上药物（多重用药）的养老院患者与药物相关问题的数量和性质。
该研究于2005年10月至2006年5月在荷兰的五家养老院（共742张床位）进行。纳入了91名多重用药患者（平均年龄80岁）。由一名医院药剂师和患者的养老院医生组成的团队进行了药物评估，六周后同一团队召开了一次跟进会议。
共识别出323个与药物相关的问题（平均每位患者3.5个问题）。在87%的患者中，62%的问题被归类为所开药物的“适应证不明确或未经证实或需要重新评估”。到随访时，每位患者平均有1.7个（n = 159）问题得到解决，每位患者的药物数量从13.5显著减少至12.7（P < 0.0001）。
大多数患者至少有一种所开药物的适应证不明。干预措施实施后，每位患者的药物数量显著减少，但一半的与药物相关问题仍未解决。
