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老年人心力衰竭的管理:治疗与机遇

Management of Heart Failure in the Older Adult: Treatment and Opportunities.

作者信息

Won Kimberly J, Bethishou Laressa, Tsu Laura V

出版信息

Sr Care Pharm. 2019 Mar 1;34(3):169-186.

Abstract

To provide a review of the available evidence regarding pharmacotherapy and areas of pharmacist intervention in transitions of care (TOC) for the geriatric population with heart failure (HF).
A PubMed search of articles published from 1995 through July 2018 was performed using a combination of the following words: heart failure, geriatric, elderly, (TOC), multidisciplinary, pharmacist.
Relevant original research, review articles, and guidelines were assessed for the management of elderly patients with HF. References from the above literature were also evaluated. Articles were selected for inclusion based on relevance to the topic, detailed methods, and complete results.
HF is a common cause of morbidity, mortality, and hospitalizations in the elderly population. While it is important that patients adhere to evidencebased medications for HF, there are additional precautions and monitoring recommendations for this population because of a higher risk of adverse effects. Elderly patients with HF also require additional care during the transition of care process because they are at high risk for readmission during this time because of a variety of factors, including medication changes, barriers to medication use, and lack of communication between health care providers. As part of a multidisciplinary team, pharmacists can help to identify and address issues.
Pharmacists can improve patient care outcomes in patients with HF by providing updated recommendations on pharmacotherapy and being involved in the TOC process.
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摘要

对老年心力衰竭(HF)患者在照护过渡(TOC)过程中药物治疗的现有证据及药剂师干预领域进行综述。

通过组合使用以下词汇对1995年至2018年7月发表在PubMed上的文章进行检索:心力衰竭、老年、年长、(照护过渡)、多学科、药剂师。

对有关老年HF患者管理的相关原始研究、综述文章和指南进行评估。还对上述文献的参考文献进行了评估。根据与主题的相关性、详细方法和完整结果选择纳入文章。

HF是老年人群发病、死亡和住院的常见原因。虽然患者坚持使用基于证据的HF药物很重要,但由于不良反应风险较高,对该人群有额外的预防措施和监测建议。老年HF患者在照护过渡过程中也需要额外的护理,因为在此期间,由于多种因素,包括药物变化、用药障碍以及医疗保健提供者之间缺乏沟通,他们再次入院的风险很高。作为多学科团队的一员,药剂师可以帮助识别和解决问题。

药剂师可以通过提供药物治疗的最新建议并参与TOC过程来改善HF患者的护理结果。

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