患有多种慢性病的居家多药联用老年患者的药物管理模式：一项系统评价方案
Medication Management Models for Polymedicated Home-Dwelling Older Adults With Multiple Chronic Conditions: Protocol of a Systematic Review.
作者信息
Pereira Filipa, Roux Pauline, Rosselet Amoussou Joëlle, Martins Maria Manuela, von Gunten Armin, Verloo Henk
机构信息
School of Health Sciences, HES-SO Valais-Wallis, Sion, Switzerland.
Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
出版信息
JMIR Res Protoc. 2019 May 28;8(5):e13582. doi: 10.2196/13582.
BACKGROUND
Older adults with multiple chronic diseases commonly require complex medication regimes. When combined with frailty, cognitive impairment, and changing pharmacological prescriptions, older adults' polymedication regimes increase the risk of medication-related problems (MRPs) and hospitalization. Effective, well-organized medication management could avoid MRPs and their clinical outcomes.
OBJECTIVE
Identify medication management models and analyze their impact on managing and preventing MRPs for polymedicated, home-dwelling older adults.
METHODS
We will conduct a systematic review of published articles in relevant professional scientific journals from inception until March 31, 2019, in the following electronic databases,: Embase; Medline OvidSP; PubMed (NOT Medline[sb]); Cumulative Index to Nursing and Allied Health Literature (CINAHL) EBSCO; PsycINFO OvidSP; Cochrane Library, Wiley; and Web of Science. We will also hand search the bibliographies of all the relevant articles found and search for unpublished studies. We will consider publications in English, French, German, Spanish, Italian, and Portuguese. Retrieved articles will be screened for eligibility. Statistical analyses will be conducted following the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statements. Data will be analyzed using SPSS Statistics for Windows, version 25.0 (IBM Corp), and Review Manager, version 5.5 (The Nordic Cochrane Centre, The Cochrane Collaboration).
RESULTS
A preliminary search in Embase delivered 3272 references. This preliminary search allows us to complete our research strategy with equation development and to search the other databases. Relevant articles identified will allow for searching the reference lists for unpublished studies. The inclusion and exclusion criteria will be rigorously respected in the study selection. The entire study is expected to be completed by January 2020.
CONCLUSIONS
This review will provide an exhaustive view of medication management models that could be effective for polymedicated, home-dwelling older adults and will allow us to analyze their impact on managing and preventing MRPs.
TRIAL REGISTRATION
PROSPERO CRD42018117287; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=117287 (Archived by WebCite at http://www.webcitation.org/77fCfbCjT).
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/13582.
背景
患有多种慢性疾病的老年人通常需要复杂的药物治疗方案。当与身体虚弱、认知障碍以及不断变化的药物处方相结合时，老年人的多重用药方案会增加药物相关问题（MRP）和住院的风险。有效、组织良好的药物管理可以避免MRP及其临床后果。
目的
确定药物管理模式，并分析其对居家多重用药老年人管理和预防MRP的影响。
方法
我们将对相关专业科学期刊自创刊至2019年3月31日发表的文章进行系统综述，检索以下电子数据库：Embase；Medline OvidSP；PubMed（不包括Medline[sb]）；护理及相关健康文献累积索引（CINAHL）EBSCO；PsycINFO OvidSP；Cochrane图书馆、Wiley；以及科学引文索引。我们还将人工检索所有找到的相关文章的参考文献，并搜索未发表的研究。我们将考虑英文、法文、德文、西班牙文、意大利文和葡萄牙文的出版物。对检索到的文章进行资格筛选。将按照《Cochrane系统评价干预措施手册》、《系统评价和荟萃分析的首选报告项目》（PRISMA）以及《流行病学观察性研究的荟萃分析》（MOOSE）声明的建议进行统计分析。将使用SPSS Statistics for Windows 25.0版（IBM公司）和Review Manager 5.5版（北欧Cochrane中心，Cochrane协作网）对数据进行分析。
结果
在Embase中进行的初步检索得到3272条参考文献。这次初步检索使我们能够通过制定方程式来完善研究策略，并检索其他数据库。识别出的相关文章将用于搜索未发表研究的参考文献列表。在研究选择过程中将严格遵守纳入和排除标准。整个研究预计于2020年1月完成。
结论
本综述将全面介绍可能对居家多重用药老年人有效的药物管理模式，并使我们能够分析其对管理和预防MRP的影响。
试验注册
PROSPERO CRD42018117287；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=117287（由WebCite存档于http://www.webcitation.org/77fCfbCjT）。
国际注册报告识别号（IRRID）：DERR1-10.2196/13582。
Zotero 插件