Wenger Nanette K, Doherty Caroline Lloyd, Gurwitz Jerry H, Hirsch Glenn A, Holmes Holly M, Maurer Matthew S, Murray Michael D
Emory University School of Medicine, 49 Jesse Hill Jr. Drive, SE, Atlanta, GA, 30303, USA.
University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Drugs Aging. 2017 Nov;34(11):803-810. doi: 10.1007/s40266-017-0494-2.
Cardiovascular disease increases incrementally with age and elderly patients concomitantly sustain multimorbidities, with resultant prescription of multiple medications. Despite conforming with disease-specific cardiovascular clinical practice guidelines, this polypharmacy predisposes many elderly individuals with cardiovascular disease to adverse drug events and non-adherence. Patient-centered care requires that the clinician explore with each patient his or her goals of care and that this shared decision-making constitutes the basis for optimization of medication management. This approach to aligning therapies with patient preferences is likely to promote patient satisfaction, to limit morbidity, and to favorably affect healthcare costs.
心血管疾病随着年龄增长而逐渐增加,老年患者同时患有多种疾病,因此需要服用多种药物。尽管遵循了特定疾病的心血管临床实践指南,但这种联合用药使许多患有心血管疾病的老年人易发生药物不良事件和治疗依从性差的问题。以患者为中心的护理要求临床医生与每位患者探讨其护理目标,这种共同决策构成了优化药物管理的基础。这种使治疗与患者偏好相一致的方法可能会提高患者满意度,降低发病率,并对医疗成本产生有利影响。