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电子处方和其他形式的技术在减少老年人不适当用药和多种用药方面的应用:当前证据综述。

Electronic prescribing and other forms of technology to reduce inappropriate medication use and polypharmacy in older people: a review of current evidence.

机构信息

HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland (RCSI), Division of Population Health Science, Beaux Lane House, Lower Mercer Street, Dublin 2, Ireland.

出版信息

Clin Geriatr Med. 2012 May;28(2):301-22. doi: 10.1016/j.cger.2012.01.009.

Abstract

This review provided an overview of the current evidence in relation to the use of e-prescribing and other forms of technology, such as CDSS, to reduce inappropriate prescribing in older people. The evidence indicates that various types of e-prescribing and CDSS interventions have the potential to reduce inappropriate prescribing and polypharmacy in older people, but the magnitude of their effect varies according to study design and setting. There was significant heterogeneity in the studies reported in terms of study designs, intervention design, patient settings, and outcome measures with patient outcomes seldom reported. Widespread diffusion of these interventions has not occurred in any of the health care settings examined. Overall, health care providers report being satisfied with e-prescribing systems and see the systems as having a positive impact on the safety of their prescribing practices, yet the problem of overriding or ignoring alerts persists. The problem of large numbers of inaccurate and insignificant alerts and this issue, along with the other barriers that have been identified, warrant further investigation.

摘要

本文综述了电子处方和其他形式的技术(如临床决策支持系统)在减少老年人不适当处方方面的应用的现有证据。证据表明,各种类型的电子处方和临床决策支持系统干预措施有可能减少老年人的不适当处方和多种药物治疗,但它们的效果大小因研究设计和环境而异。报告的研究在研究设计、干预设计、患者环境和结果测量方面存在显著的异质性,很少报告患者的结果。在检查的所有医疗保健环境中,这些干预措施都没有广泛传播。总体而言,医疗保健提供者报告对电子处方系统感到满意,并认为这些系统对其处方实践的安全性有积极影响,但仍然存在忽略或忽视警报的问题。大量不准确和不重要的警报的问题,以及已经确定的其他障碍,需要进一步调查。

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