Sestili Matteo, Logrippo Serena, Cespi Marco, Bonacucina Giulia, Ferrara Letizia, Busco Silvia, Grappasonni Iolanda, Palmieri Giovanni Filippo, Ganzetti Roberta, Blasi Paolo
Hospital Pharmacy, Italian National Research Center on Aging (INRCA), via della Montagnola 81, 60127 Ancona, Italy.
School of Pharmacy, University of Camerino, via Gentile III da Varano, 62032 Camerino, Italy.
Pharmaceutics. 2018 Dec 16;10(4):280. doi: 10.3390/pharmaceutics10040280.
Pharmaceutical formulations suitable for dysphagic patients are not always commercially available, motivating caregivers to crush tablets or open capsules to facilitate swallowing. Since this action may modify the characteristics of the medicine, it should be considered potentially inappropriate. This paper is the first to focus on how hospitalization affected the rate of potentially inappropriate prescriptions (PIPs) and the incidence of dosage form-related PIPs in elderly patients with dysphagia. Data was collected by reviewing patient medical records in the Italian National Research Center on Aging of Ancona. The therapy at admission and discharge was analysed in terms of: inappropriate drug associations, inappropriate drugs for dysphagic patients, inappropriate dosage forms and inappropriate dosage form modifications. Forty-one dysphagic patients with an average age of 88.3 years were included in the study and 451 prescriptions were analysed. PIPs were widespread at admission, and hospitalization did not improve the situation in a statistically significant manner. The most common PIPs identified (>80%) were related to dosage form selection and modification. This study highlights a clear need for continuing medical education about prescription appropriateness and modification of solid dosage forms in patients with dysphagia.
适合吞咽困难患者的药物制剂并非总能在市面上买到，这促使护理人员将片剂碾碎或打开胶囊以方便吞咽。由于这种行为可能会改变药物的特性，因此应被视为潜在的不当做法。本文首次关注住院治疗如何影响老年吞咽困难患者潜在不当处方（PIP）的发生率以及剂型相关PIP的发生率。通过查阅意大利安科纳国家老龄问题研究中心的患者病历收集数据。从以下方面分析入院和出院时的治疗情况：不当药物联合、吞咽困难患者的不当药物、不当剂型和不当剂型变更。该研究纳入了41名平均年龄为88.3岁的吞咽困难患者，并分析了451份处方。入院时PIP很普遍，住院治疗在统计学上并未显著改善这种情况。确定的最常见PIP（>80%）与剂型选择和变更有关。这项研究凸显了对吞咽困难患者进行关于处方适宜性和固体剂型变更的持续医学教育的明确需求。
