Akazawa Manabu, Nomura Kaori, Kusama Makiko, Igarashi Ataru
Meiji Pharmaceutical University, Tokyo, Japan.
Jikei University School of Medicine, Tokyo, Japan.
Value Health Reg Issues. 2012 May;1(1):98-104. doi: 10.1016/j.vhri.2012.03.001. Epub 2012 May 25.
Pharmacy-based drug utilization reviews were conducted through the Brown Bag program to understand drug-use patterns, identify potential safety concerns, and provide appropriate consultation for elderly individuals.
Community pharmacists in Hiroshima, Japan, participated in this review program from October to December 2009. Elderly individuals, 65 years or older, were recruited from community events or at pharmacies and were asked to bring all their prescription and nonprescription drugs including over-the-counter drugs and dietary supplements to the program. Pharmacists reviewed the medications and their usages and gave appropriate feedback if medications were used incorrectly, had potential interactions, or had safety concerns. The relationships among medication usage, participant responses, and potential safety concerns were analyzed by using logistic regression models. In addition, contraindications, duplicate medications, and potentially inappropriate medications were descriptively analyzed.
Drug utilization reviews were conducted on 508 elderly participants at 177 community pharmacies. Of the 508 participants, 53% were 75 years old or older and 34% were men. Twenty-four percent of the elderly participants used prescription drugs only, and 73% used both prescription and nonprescription drugs. Pharmacists offered feedback to 250 participants (49%) concerning the risk of duplication/interaction, possible adverse drug reaction that can be averted, inappropriate/unnecessary medication, nonadherence, and overdose. Two cases of contraindicated drugs, 3 cases of duplicate medications, and 327 cases of potentially inappropriate medications were identified.
The drug-use patterns among elderly individuals were identified. This medication review program conducted at community pharmacies was a useful approach to reduce concerns among users and prevent safety problems.
通过“棕色药袋”项目开展基于药房的药物利用评估，以了解用药模式，识别潜在的安全问题，并为老年人提供适当的咨询服务。
日本广岛的社区药剂师于2009年10月至12月参与了该评估项目。从社区活动或药房招募65岁及以上的老年人，并要求他们将所有处方药和非处方药（包括非处方药物和膳食补充剂）带到项目中。药剂师审查了药物及其用法，如果药物使用不当、有潜在相互作用或存在安全问题，会给予适当反馈。使用逻辑回归模型分析用药情况、参与者反应和潜在安全问题之间的关系。此外，对禁忌证、重复用药和潜在不适当用药进行了描述性分析。
在177家社区药房对508名老年参与者进行了药物利用评估。在508名参与者中，53%为75岁及以上，34%为男性。24%的老年参与者仅使用处方药，73%的参与者同时使用处方药和非处方药。药剂师就重复用药/相互作用风险、可避免的可能药物不良反应、不适当/不必要用药、用药依从性和用药过量等问题向250名参与者（49%）提供了反馈。识别出2例禁忌药物、3例重复用药和327例潜在不适当用药情况。
确定了老年人的用药模式。在社区药房开展的这项药物审查项目是减少使用者担忧并预防安全问题的有效方法。
