Warwick Medical School, University of Warwick, NHS Coventry, UK.
Diabet Med. 2012 Jan;29(1):136-9. doi: 10.1111/j.1464-5491.2011.03494.x.
To describe the numbers and costs of medications prescribed to people living with diabetes resident in nursing homes in one primary care trust in the UK.
A retrospective case notes review of 75 people with known diabetes who were resident in the 11 nursing homes in the Coventry teaching primary care trust.
Sixty-three residents (84%) were being prescribed four or more medications. Forty-four residents (59%) were prescribed anti-platelet drugs for prevention of cardiovascular disease, including aspirin, clopidogrel and dipyridamole, and 31 residents (41%) were on statin therapy. Eighteen (24%) residents had a monthly medication cost that was above £101 per month. On detailed review, these were largely residents who were being prescribed special order liquid preparations, usually for secondary cardiovascular disease prevention.
Polypharmacy, defined as taking four or more drugs per day per resident, is highly prevalent within this population of care home residents with diabetes. A high proportion of residents are prescribed drugs for cardiovascular disease prevention, which may be entirely inappropriate in this population with limited life expectancy. Regular medication review of care home residents with diabetes should be undertaken as it has the potential to reduce costs, minimize adverse drug reactions and increase health gain.
描述在英国一家初级保健信托机构的 11 家养老院居住的糖尿病患者所开药物的数量和费用。
对考文垂教学初级保健信托机构的 11 家养老院中已知患有糖尿病的 75 名居民的病历进行回顾性案例分析。
63 名居民（84%）开了四种或更多种药物。44 名居民（59%）服用抗血小板药物预防心血管疾病，包括阿司匹林、氯吡格雷和双嘧达莫，31 名居民（41%）接受他汀类药物治疗。18 名居民（24%）的每月药物费用超过 101 英镑。经详细审查，这些居民主要是服用特殊订单的液体制剂的患者，通常用于二级心血管疾病预防。
这种接受多药治疗的情况，即每天每个居民服用四种或更多种药物，在这群有糖尿病的养老院居民中非常普遍。很大一部分居民开了预防心血管疾病的药物，但对于预期寿命有限的这群人来说，这些药物可能完全不合适。应对有糖尿病的养老院居民进行常规药物审查，因为这有可能降低成本、减少药物不良反应并提高健康收益。
