Pit Sabrina W, Byles Julie E, Cockburn Jill
School of Medicine and Public Health, Faculty of Health, University of Newcastle, Royal Newcastle Hospital, Newcastle, New South Wales, Australia.
J Eval Clin Pract. 2008 Apr;14(2):203-8. doi: 10.1111/j.1365-2753.2007.00833.x. Epub 2008 Feb 18.
To describe the prevalence of risk factors for medication misadventures among older people in general practice.
Descriptive cross-sectional analysis.
General practices, New South Wales, Australia.
Twenty general practitioners in 16 practices recruited 849 practice attendees aged 65 years and over.
Risk factors for medication misadventures.
Almost all participants (95%) had used at least one medication for more than 6 months. More than half of the participants had more than one doctor involved in their care (59%), had three or more health conditions (57%), or used five or more medicines (54%). With regard to potential adverse drug reactions, in the last month 39% of participants experienced difficulties sleeping, one-third felt drowsy or dizzy (34%), and about a quarter had a skin rash (28%), leaked urine (27%), had stomach problems (22%) or had been constipated (22%). The most common compliance problems were experiencing side effects (14%) and having difficulties opening bottles or packets/applying the medicine (10%).
Risk factors for medication misadventure remain a substantial problem among older people. A Medication Risk Assessment Form completed by patients can be used as an aid to increase general practitioners' awareness of a variety of problem areas associated with medication use in a compact way, and could be used as part of a system for medication review to determine whether actions are required to improve quality use of medicines.
描述全科医疗中老年人用药差错风险因素的流行情况。
描述性横断面分析。
澳大利亚新南威尔士州的全科医疗诊所。
16家诊所的20名全科医生招募了849名65岁及以上的诊所就诊者。
用药差错的风险因素。
几乎所有参与者（95%）使用至少一种药物超过6个月。超过一半的参与者有不止一名医生参与其治疗（59%），有三种或更多健康问题（57%），或使用五种或更多药物（54%）。关于潜在的药物不良反应，在过去一个月中，39%的参与者有睡眠困难，三分之一的人感到困倦或头晕（34%），约四分之一的人有皮疹（28%）、漏尿（27%）、胃部问题（22%）或便秘（22%）。最常见的依从性问题是出现副作用（14%）以及打开瓶子或包装/用药有困难（10%）。
用药差错的风险因素在老年人中仍然是一个严重问题。患者填写的用药风险评估表可作为一种辅助工具，以简洁的方式提高全科医生对与用药相关的各种问题领域的认识，并可作为用药审查系统的一部分，以确定是否需要采取行动来改善药物的合理使用。
