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[帕金森病住院患者药物治疗管理中的挑战]

[Challenges in the pharmacotherapeutic management of the hospitalised patient with Parkinson's disease].

作者信息

Lertxundi Unax, Domingo-Echaburu Saioa, Irigoyen Irati, Isla Arantxa, Solinís M Ángeles, García-Moncó Juan C

机构信息

Red de Salud Mental de Araba, Vitoria - Gasteiz, Espana.

出版信息

Rev Neurol. 2014 Apr 16;58(8):353-64.

Abstract

Patients with Parkinson's disease (PD) are admitted to hospital more frequently and for a longer time than other patients from the same age group. The reason they are hospitalised is often different from their underlying baseline disease and they are usually attended in services with little knowledge of the disease. Both the errors made when administering levodopa and the inappropriate use of pharmacological agents with a central antidopaminergic action are relatively common during their stay in hospital. This study reports on an analysis of the literature available on the challenges and complications that patients with PD have to deal with when they are admitted to hospital, especially those that have to do with pharmacotherapy. Likewise, the authors also propose a series of strategies that lead to better care of the patients during the time they are in hospital, including aspects such as controlling the supplies of antiparkinsonian medication and establishing protocols for the therapeutic exchange of antiparkinsonian agents, as well as protocols for a suitable management of comorbidities in this kind of patients. Other strategies involve encouraging self-management of the antiparkinsonian treatment by the hospitalised patients, conducting follow-up studies to monitor inappropriate prescriptions or creating the figure of 'specialist in PD'. To do so, it will be necessary to raise the awareness of the healthcare staff at the hospital, as well as that of both patients and their relatives, about the problems derived from an inappropriate management of pharmacotherapy in PD.

摘要

帕金森病(PD)患者比同年龄组的其他患者更频繁、更长时间地住院。他们住院的原因往往与其潜在的基础疾病不同,而且通常是在对该疾病了解甚少的科室接受治疗。在住院期间,左旋多巴给药时出现的错误以及具有中枢抗多巴胺能作用的药物的不当使用都相对常见。本研究报告了对现有文献的分析,这些文献涉及PD患者住院时必须应对的挑战和并发症,特别是与药物治疗相关的问题。同样,作者还提出了一系列策略,以在患者住院期间更好地护理他们,包括控制抗帕金森药物的供应、制定抗帕金森药物治疗转换方案,以及针对这类患者合并症的适当管理方案。其他策略包括鼓励住院患者自我管理抗帕金森治疗、开展随访研究以监测不适当的处方,或设立“PD专科医生”职位。为此,有必要提高医院医护人员以及患者及其亲属对PD药物治疗管理不当所产生问题的认识。

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