Ballentine Noel H
Division of General Internal Medicine, Department of Medicine, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.
Crit Care Nurs Q. 2008 Jan-Mar;31(1):40-5. doi: 10.1097/01.CNQ.0000306395.86905.8b.
The purpose of this article is to define our current understanding of appropriate prescribing and outline the potential hazards of overprescribing, while acknowledging the benefits of modern pharmacologic treatment. Finally, we discuss practical strategies to attempt to achieve optimal prescribing patterns for the elderly. Polypharmacy, as well as inappropriate prescribing, for the elderly is a major problem and a challenge that contributes to costs, adverse drug events, confusion, compliance issues, and errors in management. A systematic approach to drug monitoring is an important aspect of appropriate prescribing. Attention to prescribing of medications, consistent review of medication lists, and reevaluation of indications and outcomes of prescribing are essential to ensure that polypharmacy is minimized and safety for patients is maximized. This article acts as a practical review for caregivers in multiple practice situations including acute care hospitals, outpatient settings, long-term care, and home care.
本文的目的是明确我们目前对合理用药的理解,并概述过度用药的潜在危害,同时认识到现代药物治疗的益处。最后,我们讨论一些实用策略,以尝试为老年人实现最佳用药模式。老年人的多重用药以及不合理用药是一个重大问题和挑战,会导致成本增加、药物不良事件、意识混乱、依从性问题以及管理失误。系统的药物监测方法是合理用药的一个重要方面。关注药物处方、持续审查用药清单以及重新评估用药指征和结果,对于确保将多重用药降至最低并使患者安全最大化至关重要。本文为包括急症医院、门诊机构、长期护理机构和家庭护理在内的多种医疗环境中的护理人员提供了一份实用综述。