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老年慢性心力衰竭患者家中储存药物的分析。

Analyses of drugs stored at home by elderly patients with chronic heart failure.

作者信息

Ewen Sebastian, Baumgarten Tanja, Rettig-Ewen Volker, Mahfoud Felix, Griese-Mammen Nina, Schulz Martin, Böhm Michael, Laufs Ulrich

机构信息

Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Str., Geb. 40, 66421, Homburg/Saar, Germany,

出版信息

Clin Res Cardiol. 2015 Apr;104(4):320-7. doi: 10.1007/s00392-014-0783-2. Epub 2014 Nov 6.

Abstract

BACKGROUND

Evidence-based pharmacotherapy improves morbidity and mortality in patients with chronic heart failure (CHF). Medication adherence management is important for the effectiveness and safety of treatment. This study investigated drugs stored at home by elderly CHF patients.

METHODS AND RESULTS

One hundred and one patients with stable CHF age ≥65 years were visited at home where a standardized interview and a thorough assessment of medication were performed. Mean age of the patients was 77.7 ± 6.1 years, 53 % male, mean NYHA functional class of 2.8 ± 0.7 and a Minnesota-Living-with-Heart-Failure score of 59.4 ± 28.6 points indicating reduced quality of life. The mean number of different drug packs per patient was 13.1 ± 5.5, corresponding to a mean indexed value per patient of 403 ± 48. Cardiovascular drugs accounted for 32 % of the packs. On average, 2.4 ± 3.2 packs contained medication that was not taken by the patient (18 % of the medication, mean indexed value 61 ± 8). Fifty-six percent of the unused drugs were prescribed by general practitioners, 23 % in the hospital, and 7 % by medical specialists and 14 % were over-the-counter drugs. Sixty-three packages (5 %) of the drugs at home were expired (mean indexed value per patient 12 ± 3).

CONCLUSION

On average, elderly patients with CHF have to manage 13 different drug packs per day at home of which a significant portion is not taken as prescribed. New strategies are needed to support medicines management at home.

摘要

背景

循证药物治疗可改善慢性心力衰竭(CHF)患者的发病率和死亡率。药物依从性管理对治疗的有效性和安全性至关重要。本研究调查了老年CHF患者在家中储存的药物。

方法与结果

对101例年龄≥65岁的稳定型CHF患者进行了家访,进行了标准化访谈并对药物进行了全面评估。患者的平均年龄为77.7±6.1岁,男性占53%,平均纽约心脏协会(NYHA)心功能分级为2.8±0.7,明尼苏达心力衰竭生活评分59.4±28.6分,表明生活质量下降。每位患者不同药包的平均数量为13.1±5.5个,对应每位患者的平均索引值为403±48欧元。心血管药物占药包的32%。平均而言,2.4±3.2个药包中的药物患者未服用(占药物的18%,平均索引值61±8欧元)。56%的未使用药物由全科医生开具,23%在医院开具,7%由医学专家开具,14%为非处方药。家中63包(5%)药物过期(每位患者的平均索引值12±3欧元)。

结论

平均而言,老年CHF患者在家中每天要管理13种不同的药包,其中很大一部分未按规定服用。需要新的策略来支持家庭药物管理。

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