Gillette Chris, Prunty Leesa, Wolcott Janet, Broedel-Zaugg Kimberly
Marshall University School of Pharmacy, Department of Pharmacy Practice, Administration, and Research, 1 John Marshall Dr., Huntington, WV 25755, USA.
Marshall University School of Pharmacy, Department of Pharmacy Practice, Administration, and Research, 1 John Marshall Dr., Huntington, WV 25755, USA.
Res Social Adm Pharm. 2015 May-Jun;11(3):468-71. doi: 10.1016/j.sapharm.2014.08.010. Epub 2014 Aug 28.
Previous research suggests that polypharmacy is a significant challenge for health care systems. However, polypharmacy has been defined in at least 24 distinct ways, which has understandably caused confusion among researchers, educators, and students in health care. Previous definitions of polypharmacy capture what could be both inappropriate therapy, i.e. too many medications, as well as evidence-based therapy that is appropriate. Previous research has tried to focus on the number of medications a patient is prescribed to define polypharmacy; however only focusing on the number of medications a patient is taking may be of limited value in determining whether that patient will experience an adverse event. This paper proposes a lexicon change for polypharmacy. It suggests that in future research, polypharmacy be defined as patients going to more than one pharmacy for their prescriptions. The authors also proffer a new term, 'extraordinary prescribing,' to define patients who are taking medications that are either grossly excessive or not beneficial for that patient. This definition is different than the current use of polypharmacy because the number of medications a patient is taking is irrelevant, especially if that patient has multiple chronic diseases. This paper is meant to start a dialog within the health services research community to inform future research that examines why inefficient prescribing may harm patients and the broader health care system.
先前的研究表明，多重用药是医疗保健系统面临的一项重大挑战。然而，多重用药至少有24种不同的定义方式，这在医疗保健领域的研究人员、教育工作者和学生中造成困惑也就不足为奇了。先前对多重用药的定义既涵盖了可能不适当的治疗，即用药过多，也包括了适当的循证治疗。先前的研究试图专注于患者所开药物的数量来定义多重用药；然而，仅关注患者正在服用的药物数量，对于确定该患者是否会发生不良事件可能价值有限。本文提议对多重用药的词汇进行更改。它建议在未来的研究中，将多重用药定义为患者前往不止一家药房开具处方。作者还提出了一个新术语“超常处方”，来定义那些正在服用严重过量或对该患者无益药物的患者。这个定义与当前对多重用药的用法不同，因为患者服用药物的数量并不相关，尤其是当该患者患有多种慢性病时。本文旨在在卫生服务研究界展开一场对话，为未来研究提供信息，该研究将探讨低效处方为何可能损害患者及更广泛的医疗保健系统。
