Kiesel Esther, Hopf Yvonne
Department of Pharmacy, University Hospital of Munich, Munich, Germany.
Eur J Hosp Pharm. 2018 Mar;25(e1):e74-e81. doi: 10.1136/ejhpharm-2017-001239. Epub 2017 Aug 2.
Multimorbidity of geriatric patients often leads to polypharmacy that increases the risk for drug interactions. Geriatric patients are also more sensitive to adverse drug reactions due to physiological changes resulting from ageing. Hence, the use of medicines should be considered thoroughly. This systematic literature review aimed at identifying and presenting available evidence on the effect of pharmaceutical interventions on geriatric patients, their medications or healthcare costs in a clinical setting in Europe.
We included all studies on research of pharmaceutical interventions on geriatric inpatients (≥65 years) in Europe since 2001. Database searches were conducted on PubMed, EMBASE, The Cochrane Library and AgeInfo. In addition, the following journals were searched manually: , '', '' and ''.
Database screening yielded 8058 hits. After deletion of duplicates, screening of title and abstract, 143 full-text articles were analysed and 17 papers were included. Manual searching added four more papers. Included studies were conducted in Belgium, Denmark, England, Ireland, the Netherlands, Sweden and Spain. They demonstrate that pharmaceutical care on wards leads to more appropriate medication use and might reduce outcomes like drug-related readmissions. Intensified pharmaceutical care showed additional effects, even in countries with established pharmaceutical care in hospitals.
This systematic literature review demonstrates that ward-based pharmacists may improve the appropriateness of medications, seamless care and drug safety for geriatric inpatients while being cost effective.
老年患者的多种疾病常常导致多重用药，增加了药物相互作用的风险。由于衰老引起的生理变化，老年患者对药物不良反应也更为敏感。因此，用药应经过充分考虑。本系统文献综述旨在识别并呈现关于药物干预对欧洲临床环境中老年患者、其用药或医疗费用影响的现有证据。
我们纳入了自2001年以来欧洲关于老年住院患者（≥65岁）药物干预研究的所有文献。在PubMed、EMBASE、Cochrane图书馆和AgeInfo上进行了数据库检索。此外，还手动检索了以下期刊：《》《》《》和《》。
数据库筛选得到8058条记录。在删除重复项、筛选标题和摘要后，对143篇全文进行了分析，纳入了17篇论文。手动检索又增加了4篇论文。纳入的研究在比利时、丹麦、英格兰、爱尔兰、荷兰、瑞典和西班牙开展。这些研究表明，病房药学服务可使用药更合理，并可能减少与药物相关的再入院等情况。强化药学服务显示出额外的效果，即使在医院已有药学服务的国家也是如此。
本系统文献综述表明，病房药师可为老年住院患者提高用药合理性、无缝护理和用药安全性，同时具有成本效益。
