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老年人、多病共存或多病理患者慢性病用药不当。

Inappropriate Use of Medication by Elderly, Polymedicated, or Multipathological Patients with Chronic Diseases.

机构信息

Health Psychology Department, Miguel Hernandez University, 03202 Elche, Alicante, Spain.

Sant Joan-Alacant Health District, Conselleria Sanitat, 03202 Elche, Alicante, Spain.

出版信息

Int J Environ Res Public Health. 2018 Feb 10;15(2):310. doi: 10.3390/ijerph15020310.

Abstract

The growth of the aging population leads to the increase of chronic diseases, of the burden of multimorbility, and of the complexity polypharmacy. The prevalence of medication errors rises in patients with polypharmacy in primary care, and this is a major concern to healthcare systems. This study reviews the published literature on the inappropriate use of medicines in order to articulate recommendations on how to reduce it in chronic patients, particularly in those who are elderly, polymedicated, or multipathological. A systematic review of articles published from January 2000 to October 2015 was performed using MEDLINE, EMBASE, PsychInfo, Scopus, The Cochrane Library, and Index Medicus databases. We selected 80 studies in order to analyse the content that addressed the question under consideration. Our literature review found that half of patients know what their prescribed treatment is; that most of elderly people take five or more medications a day; that in elderly, polymedicated people, the probability of a medication error occurring is higher; that new tools have been recently developed to reduce errors; that elderly patients can understand written information but the presentation and format is an important factor; and that a high percentage of patients have remaining doubts after their visit. Thus, strategies based on the evidence should be applied in order to reduce medication errors.

摘要

人口老龄化导致慢性病、多病共存负担以及药物治疗复杂性的增加。在初级保健中,接受多种药物治疗的患者中药物错误的发生率上升,这是医疗保健系统的主要关注点。本研究回顾了已发表的关于药物不当使用的文献,以制定如何减少慢性患者,特别是老年、多药治疗或多病理患者药物错误的建议。使用 MEDLINE、EMBASE、PsychInfo、Scopus、The Cochrane Library 和 Index Medicus 数据库,对 2000 年 1 月至 2015 年 10 月期间发表的文章进行了系统评价。我们选择了 80 项研究,以分析所考虑问题的内容。我们的文献回顾发现,一半的患者知道自己的处方治疗是什么;大多数老年人每天服用五种或更多药物;在老年人、多药治疗的人群中,发生药物错误的概率更高;最近开发了一些新的工具来减少错误;老年患者可以理解书面信息,但呈现和格式是一个重要因素;并且有很大比例的患者在就诊后仍有疑问。因此,应该应用基于证据的策略来减少药物错误。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c826/5858379/cb6eed307edc/ijerph-15-00310-g001.jpg

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