Chiang-Hanisko Lenny, Tan Jung-Ying, Chiang Ling-Chun
Christine E. Lynn College of Nursing, Florida Atlantic University, USA.
Department of Nursing, HungKuang University, Taiwan, ROC.
Hu Li Za Zhi. 2014 Jun;61(3):97-104. doi: 10.6224/JN.61.3.97.
Polypharmacy is a major concern in the care of older adults. People over 65 years of age frequently have multiple medical conditions and may have cancer, which requires multiple medications for treatment. The use of multiple medications increases the risk of drug-drug interactions, non-adherence, and adverse drug reactions. Polypharmacy is a term that refers to a high number of prescribed medications, usually five and above, or the use of more medications than is clinically justified. Although medications are an important factor in improving and maintaining the quality of life of older adults, polypharmacy increases the risks of morbidity and mortality, loss of functional independence, and a multiplicity of cognitive and physical problems in this population. This article examines issues related to polypharmacy in older adults and identifies nursing strategies and interventions to detect and prevent polypharmacy. Nursing strategies discussed include: (1) increasing patient knowledge of pharmacological issues, (2) increasing patient medication management competency, (3) promoting safe patient medication practices, and (4) enhancing patient education. Nurses must be familiar with medicine regimens, understand the primary factors that affect adherence, and participate in continuing education to enhance their ability to safeguard older adult patients.
多重用药是老年护理中的一个主要问题。65岁以上的人群经常患有多种疾病，可能还患有癌症，这需要多种药物进行治疗。使用多种药物会增加药物相互作用、不依从性和药物不良反应的风险。多重用药是指大量的处方药，通常为五种及以上，或者使用的药物数量超过临床合理用量。尽管药物是改善和维持老年人生活质量的重要因素，但多重用药会增加该人群发病和死亡的风险、丧失功能独立性以及出现多种认知和身体问题。本文探讨了与老年人多重用药相关的问题，并确定了检测和预防多重用药的护理策略及干预措施。讨论的护理策略包括：（1）增加患者对药理学问题的了解，（2）提高患者的用药管理能力，（3）促进患者安全用药实践，以及（4）加强患者教育。护士必须熟悉用药方案，了解影响依从性的主要因素，并参与继续教育以提高保护老年患者的能力。
