2006年至2013年瑞典老年人不适当药物治疗处方的趋势：使用国家指标进行评估。
Trends in inappropriate drug therapy prescription in the elderly in Sweden from 2006 to 2013: assessment using national indicators.
作者信息
Hovstadius Bo, Petersson Göran, Hellström Lina, Ericson Lisa
机构信息
Department of Medicine and Optometry, eHealth Institute, Linnaeus University, 391 82, Kalmar, Sweden,
出版信息
Drugs Aging. 2014 May;31(5):379-86. doi: 10.1007/s40266-014-0165-5.
BACKGROUND
Medication for elderly patients is often complex and problematic. Several criteria for classifying inappropriate prescribing exist. In 2010, the Swedish National Board of Health and Welfare published the document "Indicators of appropriate drug therapy in the elderly" as a guideline for improving prescribing for the elderly.
OBJECTIVE
The aim of this study was to assess trends in the prescription of inappropriate drug therapy in the elderly in Sweden from 2006 to 2013 using national quality indicators for drug treatment.
METHODS
Individual-based data on dispensed prescription drugs for the entire Swedish population aged ≥65 years during eight 3-month periods from 2006 to 2013 were accumulated. The data were extracted from the Swedish Prescribed Drug Register. Eight drug-specific quality indicators were monitored.
RESULTS
For the entire population studied (n = 1,828,283 in 2013), six of the eight indicators showed an improvement according to the guidelines; the remaining two indicators (drugs with anticholinergic effects and excessive polypharmacy) remained relatively unchanged. For the subgroup aged 65-74 years, three indicators showed an improvement, four indicators remained relatively unchanged (e.g. propiomazine, and oxazepam) and one showed an undesirable trend (anticholinergic drugs) according to guidelines. For the older group (aged ≥75 years), all indicators except excessive polypharmacy showed improvement.
CONCLUSION
According to the quality indicators used, the extent of inappropriate drug therapy in the elderly decreased from 2006 to 2013 in Sweden. Thus, prescribers appear to be more likely to change their prescribing patterns for the elderly than previously assumed.
背景
老年患者的用药往往复杂且存在问题。存在多种不适当处方的分类标准。2010年，瑞典国家卫生和福利委员会发布了文件《老年人合理药物治疗指标》，作为改善老年人处方的指南。
目的
本研究的目的是利用国家药物治疗质量指标评估2006年至2013年瑞典老年人不适当药物治疗处方的趋势。
方法
收集了2006年至2013年期间八个3个月时间段内瑞典全体65岁及以上人口的个人配药处方药数据。数据从瑞典处方药登记册中提取。监测了八项特定药物的质量指标。
结果
在整个研究人群中（2013年为n = 1,828,283），八项指标中有六项根据指南显示有所改善；其余两项指标（具有抗胆碱能作用的药物和过度多重用药）相对保持不变。对于65 - 74岁的亚组，三项指标显示有所改善，四项指标相对保持不变（如丙酰异丙嗪和奥沙西泮），一项指标根据指南显示有不良趋势（抗胆碱能药物）。对于年龄较大的组（75岁及以上），除过度多重用药外的所有指标均显示有所改善。
结论
根据所使用的质量指标，2006年至2013年瑞典老年人不适当药物治疗的程度有所下降。因此，开处方者似乎比以前认为的更有可能改变他们为老年人开处方的模式。
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