Sakakibara Mikio, Igarashi Ataru, Takase Yoshimasa, Kamei Hiroyuki, Nabeshima Toshitaka
NPO Japanese Drug Organization of Appropriate Use and Research. Sugi Pharmacy Co., Ltd. Office of Clinical Pharmacy Practice and Health Care Management, Faculty of Pharmacy, Meijo University..
J Pharm Pharm Sci. 2015;18(5):705-12. doi: 10.18433/j37p5x.
Due to the use of multiple drugs and prevalence of diminished cognitive function, community-dwelling elderly individuals are more likely to have drug-related issues. We examined changes in quality of life (QOL) and activities of daily living (ADL) 3 months and 6 months after reducing drug use of dementia patients who had newly begun community-dwelling care.
Prescription drug use was reduced in the intervention group, whereas the non-intervention group continued their regimen or began using additional drugs. QOL and ADL were assessed with the Japanese version of the EQ-5D and the Barthel Index, respectively.
Subjects were 32 individuals aged ≥65 years who had begun community-dwelling between March and July 2014 and had received approval for long-term care insurance. On average, the intervention group (n = 19) stopped using 2.6 prescription drugs. After 6 months, the differences in the QOL and ADL scores in the intervention group were -0.03 ± 0.29 and 6.32 ± 18.6, respectively, while the differences in the QOL and ADL scores in the non-intervention group (n = 13) were -0.13 ± 0.29 and -2.69 ± 23.7, respectively. In the intervention group, ADL scores were significantly increased by 14.0 ± 11.1 6 months after reduced benzodiazepine use.
QOL was maintained with reduced drug use, while ADL score was slightly increased. In addition, the reduction of benzodiazepine use significantly increased ADL. In order to reduce polypharmacy among community-dwelling elderly patients, it is necessary to create an opportunity for pharmacists to re-examine their prescriptions.
由于多种药物的使用以及认知功能减退的普遍存在,居住在社区的老年人更有可能出现与药物相关的问题。我们研究了新开始接受社区居家护理的痴呆患者减少药物使用3个月和6个月后生活质量(QOL)和日常生活活动能力(ADL)的变化。
干预组减少处方药的使用,而非干预组继续其用药方案或开始使用额外的药物。分别使用日语版的EQ-5D和Barthel指数评估生活质量和日常生活活动能力。
研究对象为32名年龄≥65岁的个体,他们于2014年3月至7月开始社区居家生活,并已获得长期护理保险批准。平均而言,干预组(n = 19)停用了2.6种处方药。6个月后,干预组的生活质量和日常生活活动能力得分差异分别为-0.03±0.29和6.32±18.6,而非干预组(n = 13)的生活质量和日常生活活动能力得分差异分别为-0.13±0.29和-2.69±23.7。在干预组中,减少苯二氮䓬类药物使用6个月后,日常生活活动能力得分显著提高了14.0±11.1。
减少药物使用可维持生活质量,同时日常生活活动能力得分略有提高。此外,减少苯二氮䓬类药物的使用显著提高了日常生活活动能力。为了减少社区居家老年患者的多重用药情况,有必要为药剂师创造重新审查其处方的机会。