Bear Michael D, Bartlett Donna, Evans Paula
Consult Pharm. 2017 Mar 1;32(3):161-168. doi: 10.4140/TCP.n.2017.161.
To determine the impact a medication review has on the detection and use of nonsteroidal anti-inflammatory drugs (NSAIDs) by older adults compared with non-NSAID users in regard to interacting drug classes, interacting comorbidities, and prior counseling by providers.
Prospective, quasi-experiment without control.
Ambulatory.
Patients 60 years of age and older who contacted the pharmacy outreach program. In total, 83 patients consented. Twenty-eight patients were eligible for three-month follow-up.
Pharmacists and pharmacy students provided NSAID counseling.
Patient-reported changes of NSAID use, change from inappropriate to appropriate use, impression of risk awareness, and further discussion with health care providers.
NSAID use was reported by 39 (47.6%) of 83 patients. Inappropriate use was detected in 28 (71.8%) of NSAID users; of these, 18 (64.3%) were reached for post-counseling follow-up. The number of appropriate users increased to 20 (51.3%), with a concomitant reduction of inappropriate users to 19 (48.7%). Nine (50%) reported change in the use of NSAIDs, 13 (72.2%) had a better understanding of the risks associated with NSAID use, and 10 (55.6%) had a more meaningful conversation with providers.
Older adults who use NSAIDs may be unaware of potential risks. Counseling older adults may reduce potentially inappropriate use and increase patient risk awareness. Pharmacists can improve their role in recognizing and counseling patients on NSAIDs.
确定药物审查对老年人非甾体抗炎药(NSAIDs)的检测和使用产生的影响,并与非NSAIDs使用者在相互作用的药物类别、相互作用的合并症以及提供者先前的咨询方面进行比较。
前瞻性、无对照的准实验。
门诊。
60岁及以上联系药房外展项目的患者。共有83名患者同意参与。28名患者符合三个月随访条件。
药剂师和药学专业学生提供NSAIDs咨询。
患者报告的NSAIDs使用变化、从不适当使用转变为适当使用、风险意识印象以及与医疗保健提供者的进一步讨论。
83名患者中有39名(47.6%)报告使用NSAIDs。在NSAIDs使用者中,检测到28名(71.8%)存在不适当使用情况;其中,18名(64.3%)在咨询后接受了随访。适当使用者的数量增加到20名(51.3%),不适当使用者相应减少到19名(48.7%)。9名(50%)报告NSAIDs使用有变化,13名(72.2%)对NSAIDs使用相关风险有了更好的理解,10名(55.6%)与提供者进行了更有意义的交谈。
使用NSAIDs的老年人可能未意识到潜在风险。对老年人进行咨询可能会减少潜在的不适当使用,并提高患者的风险意识。药剂师可以改善他们在识别和为使用NSAIDs的患者提供咨询方面的作用。