长期护理机构居民药物治疗复杂性评估：一项横断面描述性研究。
Evaluation of pharmacotherapy complexity in residents of long-term care facilities: a cross-sectional descriptive study.
作者信息
Alves-Conceição Vanessa, Silva Daniel Tenório da, Santana Vanessa Lima de, Santos Edileide Guimarães Dos, Santos Lincoln Marques Cavalcante, Lyra Divaldo Pereira de
机构信息
Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, SE, Brazil; Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, CEP: 49100-000, Brazil.
Group of Studies in Geriatrics and Gerontology, College of Pharmacy, Federal University of Vale do São Francisco, Petrolina, Brazil.
出版信息
BMC Pharmacol Toxicol. 2017 Jul 25;18(1):59. doi: 10.1186/s40360-017-0164-3.
BACKGROUND
Polypharmacy is a reality in long-term care facilities. However, number of medications used by the patient should not be the only predictor of a complex pharmacotherapy. Although the level of complexity of pharmacotherapy is considered an important factor that may lead to side effects, there are few studies in this field. The aim of this study was to evaluate the complexity of pharmacotherapy in residents of three long-term care facilities.
METHODS
A cross-sectional study was performed to evaluate the complexity of pharmacotherapy using the protocols laid out in the Medication Regimen Complexity Index instrument in three long-term care facilities in northeastern Brazil. As a secondary result, potential drug interactions, potentially inappropriate medications, medication duplication, and polypharmacy were evaluated. After the assessment, the association among these variables and the Medication Regimen Complexity Index was performed.
RESULTS
In this study, there was a higher prevalence of women (64.4%) with a high mean age among the study population of 81.8 (±9.7) years. The complexity of pharmacotherapy obtained a mean of 15.1 points (±9.8), with a minimum of 2 and a maximum of 59. The highest levels of complexity were associated with dose frequency, with a mean of 5.5 (±3.6), followed by additional instructions of use averaging 4.9 (±3.7) and by the dosage forms averaging 4.6 (±3.0).
CONCLUSIONS
The present study evaluated some factors that complicate the pharmacotherapy of geriatric patients. Although polypharmacy was implicated as a factor directly related to complexity, other indicators such as drug interactions, potentially inappropriate medications, and therapeutic duplication can also make the use of pharmacotherapy in such patients more difficult.
背景
在长期护理机构中，多重用药是一种现实情况。然而，患者使用的药物数量不应是复杂药物治疗的唯一预测指标。尽管药物治疗的复杂程度被认为是可能导致副作用的一个重要因素，但该领域的研究较少。本研究的目的是评估三家长期护理机构中居民的药物治疗复杂性。
方法
采用横断面研究，使用巴西东北部三家长期护理机构中药物治疗方案复杂性指数工具所规定的方案来评估药物治疗的复杂性。作为次要结果，评估了潜在的药物相互作用、潜在不适当的药物、药物重复和多重用药情况。评估后，对这些变量与药物治疗方案复杂性指数之间的关联进行了分析。
结果
在本研究中，研究人群中女性患病率较高（64.4%），平均年龄较高，为81.8（±9.7）岁。药物治疗复杂性的平均得分为15.1分（±9.8），最低为2分，最高为59分。最高的复杂程度与给药频率相关，平均为5.5（±3.6），其次是平均为4.9（±3.7）的附加使用说明和平均为4.6（±3.0）的剂型。
结论
本研究评估了一些使老年患者药物治疗复杂化的因素。尽管多重用药被认为是与复杂性直接相关的一个因素，但其他指标，如药物相互作用、潜在不适当的药物和治疗重复，也会使此类患者的药物治疗更加困难。
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