Dunn Rebecca L, Harrison Donald, Ripley Toni L
Department of Pharmacy: Clinical and Administrative Sciences, University of Oklahoma Health Sciences Center College of Pharmacy, Oklahoma City, Oklahoma.
Consult Pharm. 2011 Oct;26(10):754-63. doi: 10.4140/TCP.n.2011.754.
To determine the impact of using the Beers criteria (sometimes known as the Beers list) as an outpatient screening tool on the number or dosage of Beers criteria medications identified in patients' medication profiles immediately before an outpatient appointment.
Nonrandomized, prospective pre-/post pilot study.
Six individual medicine and medicine-specialty clinics at a major academic medical center.
All subjects were 65 years of age or older.
Subjects 65 years of age or older had their medication profiles screened using the Beers criteria- medications potentially inappropriate for use in the elderly- prior to and directly after a scheduled appointment with their physician. Respective physicians were notified of any Beers criteria medications before the appointments. Physician options were to discontinue, continue, or change the dose of the medications identified with the option for justification of their decision.
The difference from baseline (preappointment) to follow-up (postappointment) in the number or dosage of Beers criteria medications identified in patients' profiles.
120 eligible charts were reviewed. The average age of subjects was 74 years. Overall, 37.5% of subjects were on potentially inappropriate medications (PIMs) as defined by the Beers criteria. Sixty-three PIMs were flagged out of 120 profiles. For the primary outcome, 8/63 and 0/63 PIMs were discontinued or had a dosage change, respectively. This intervention resulted in a statistically significant reduction in the mean number of Beers criteria medications (P = 0.032).
Use of the Beers criteria as a clinical intervention tool in an outpatient setting may be an effective method to reduce the number of PIMs prescribed in an elderly population.
确定将Beers标准（有时称为Beers清单）用作门诊筛查工具，对门诊预约前患者用药记录中所识别出的Beers标准药物数量或剂量的影响。
非随机前瞻性前后对照试点研究。
某大型学术医疗中心的六个独立内科及内科专科诊所。
所有受试者年龄均在65岁及以上。
65岁及以上的受试者在与医生进行预约前和预约后，使用Beers标准（即可能不适用于老年人的药物）对其用药记录进行筛查。预约前会将任何符合Beers标准的药物通知相应的医生。医生可选择停用、继续使用或更改所识别药物的剂量，并需为其决定说明理由。
患者记录中所识别出的Beers标准药物数量或剂量从基线（预约前）到随访（预约后）的差异。
共审查了120份符合条件的病历。受试者的平均年龄为74岁。总体而言，37.5%的受试者正在使用Beers标准定义的潜在不适当药物（PIMs）。120份记录中共标记出63种PIMs。对于主要观察指标，分别有8/63和0/63种PIMs被停用或更改了剂量。该干预措施使Beers标准药物的平均数量在统计学上显著减少（P = 0.032）。
在门诊环境中使用Beers标准作为临床干预工具，可能是减少老年人群中所开具的PIMs数量的有效方法。
