Peralta-Pedrero María Luisa, Valdivia-Ibarra Francisco Javier, Hernández-Manzano Mario, Medina-Beltrán Gustavo Rodrigo, Cordero-Guillén Miguel Angel, Baca-Zúñiga José, Cruz-Avelar Agles, Aguilar-Salas Ismael, Avalos-Mejía Annia Marisol
División de Excelencia Clínica, Coordinación de Unidades Médicas de Alta Especialidad, Distrito Federal, Instituto Mexicano del Seguro Social, México.
Rev Med Inst Mex Seguro Soc. 2013 Mar-Apr;51(2):228-39.
The process of prescribing a medication is complex and includes: deciding whether it is indicated, choosing the best option, determining the dose and the appropriate management scheme to the physiological condition of the patient, and monitoring effectiveness and toxicity. We have to inform patients about the expected side effects and indications for requesting a consultation. Specific clinical questions were designed based on the acronym PICOST. The search was made in the specific websites of clinical practice guidelines, was limited to the population of older adults, in English or Spanish. We used 10 related clinical practice guidelines, eight systematic reviews and five meta-analyses. Finally, we made a search of original articles or clinical reviews for specific topics. The development and validation of clinical practice guidelines for "rational drug prescriptions in the elderly" is intended to promote an improvement in the quality of prescription through the prevention and detection of inappropriate prescribing in the elderly and, as a result of this, a decrease in the adverse events by drugs, deterioration of health of patients and expenditure of resources.
开药过程很复杂，包括：确定是否有用药指征、选择最佳药物、根据患者生理状况确定剂量和适当的治疗方案，以及监测疗效和毒性。我们必须告知患者预期的副作用以及咨询的指征。基于首字母缩写词PICOST设计了具体的临床问题。检索在临床实践指南的特定网站上进行，限于老年人，语言为英语或西班牙语。我们使用了10份相关临床实践指南、8份系统评价和5份荟萃分析。最后，我们针对特定主题检索了原始文章或临床综述。“老年人合理用药处方”临床实践指南的制定和验证旨在通过预防和发现老年人不适当处方，促进处方质量的提高，从而减少药物不良事件、患者健康恶化和资源消耗。
