eHealth Institute, Linnaeus University, Bredbandet 1, PO SE-391 82 Kalmar, Sweden.
Clin Geriatr Med. 2012 May;28(2):159-72. doi: 10.1016/j.cger.2012.01.001. Epub 2012 Feb 15.
There are numerous risk factors for patients to develop excessive polypharmacy. The most prominent risk factors are associated with sociodemographics and the patients’ conditions. Risk factors associated with patient behavior, such as patient’s self medication with all types of medications, have not been observed to the same extent but might be at the same level of importance for patients developing excessive polypharmacy. Risk factors related to physicians, and the interaction between patient and physician, are studied to a much lesser extent. The few studies conducted regarding the large variation in physicians’ individual prescribing practices, in terms of polypharmacy, add another perspective to the complexity of the area. Interventions aiming to improve communication between GP and hospital specialist, to create support systems for medical reviews that include all patients’ medications, and to improve the knowledge of multiple prescribing might have the largest potential to better manage excessive polypharmacy.
患者过度用药的风险因素有很多。最突出的风险因素与社会人口统计学和患者状况有关。与患者行为相关的风险因素，如患者自行使用各种药物，虽然没有观察到同样程度，但可能对患者过度用药的发生具有同等重要性。与医生相关的风险因素，以及医患之间的相互作用，研究得要少得多。针对医生个体在药物联合使用方面的处方实践存在较大差异的少数研究，为该领域的复杂性增添了另一个视角。旨在改善全科医生和医院专家之间沟通、为包括所有患者用药在内的医疗审查创建支持系统、提高多重处方知识的干预措施，可能有最大的潜力来更好地管理过度用药。
