Bergkvist Anna, Midlöv Patrik, Höglund Peter, Larsson Lisa, Eriksson Tommy
Hospital Pharmacy, University Hospital MAS, Malmö, Sweden.
J Eval Clin Pract. 2009 Aug;15(4):660-7. doi: 10.1111/j.1365-2753.2008.01080.x.
RATIONALE, AIMS AND OBJECTIVES: To evaluate if an integrated medicines management can lead to a more appropriate drug use in elderly inpatients.
The study was an intervention study at a department of internal medicine in southern Sweden. During the intervention period pharmacists took part in the daily work at the wards. Systematic interventions aiming to identify, solve and prevent drug-related problems (DRPs) were performed during the patient's hospital stay by multidisciplinary teams consisting of physicians, nurses and pharmacists. DRPs identified by the pharmacist were put forward to the care team and discussed. Medication Appropriateness Index (MAI) was used to evaluate the appropriateness in the patients' drug treatment at admission, discharge and 2 weeks after discharge. In total 43 patients were included, 28 patients in the intervention group and 25 patients in the group which was used as control.
For the intervention group there was a significant decrease in the number of inappropriate drugs compared with the control group (P = 0.049). Indication, duration and expenses were the MAI-dimensions with most inappropriate ratings, and the drugs with most inappropriate ratings were anxiolytics, hypnotics and sedatives.
This kind of systematic approach on drug therapy can result in a more appropriate drug use in the elderly.
原理、目的与目标：评估综合药物管理是否能使老年住院患者的用药更合理。
该研究是在瑞典南部一家内科进行的干预性研究。在干预期间，药剂师参与病房的日常工作。由医生、护士和药剂师组成的多学科团队在患者住院期间进行旨在识别、解决和预防药物相关问题（DRP）的系统性干预。药剂师识别出的DRP会提交给护理团队并进行讨论。用药合理性指数（MAI）用于评估患者入院时、出院时及出院后2周药物治疗的合理性。总共纳入43例患者，干预组28例，对照组25例。
与对照组相比，干预组的不合理用药数量显著减少（P = 0.049）。适应证、疗程和费用是MAI评分中最不合理的维度，评分最不合理的药物是抗焦虑药、催眠药和镇静剂。
这种药物治疗的系统性方法可使老年人用药更合理。
