Neuner-Jehle Stefan, Krones Tanja, Senn Oliver
Institut für Hausarztmedizin Zürich, Universität Zürich.
Abteilung Klinische Ethik, Universitätsspital Zürich und Universität Zürich.
Praxis (Bern 1994). 2014 Mar 12;103(6):317-22. doi: 10.1024/1661-8157/a001591.
Polypharmacy increasingly is a problem in the care of polymorbid and elderly people, and affects morbidity and mortality. We adapted an algorithm for systematic deprescribing of medicaments (Good Palliative Geriatric Practice, developed for geriatric patients originally), and performed a practicability and acceptance study with 14 general practitioners and 63 patients with 523 medicaments totally. By the intervention 13% of all medicaments could be changed and 9% stopped, mostly (56%) due to an absence of indication. 75% of patients given a recommendation to change a medicament agreed. Acceptance and practicability of the tool were rated clearly positive by physicians. To study efficacy a randomized-controlled trial with clinical outcomes, long-term follow up and the exploration of patients' views is warranted.
多重用药在多病共存的老年人护理中日益成为一个问题，并影响发病率和死亡率。我们改编了一种用于系统减停药物的算法（最初为老年患者开发的良好姑息性老年医学实践），并对14名全科医生和63名患者（共使用523种药物）进行了实用性和接受度研究。通过干预，所有药物中有13%可以更改，9%可以停用，大部分（56%）是因为没有用药指征。75%收到更改药物建议的患者表示同意。医生对该工具的接受度和实用性评价明显为积极。有必要开展一项具有临床结局、长期随访并探索患者观点的随机对照试验来研究其疗效。
