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澳大利亚老年护理机构药物审查的过程、影响及结果:一项系统综述。

Process, impact and outcomes of medication review in Australian residential aged care facilities: A systematic review.

作者信息

Chen Esa Y H, Wang Kate N, Sluggett Janet K, Ilomäki Jenni, Hilmer Sarah N, Corlis Megan, Bell J Simon

机构信息

Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia.

NHMRC Cognitive Decline Partnership Centre, University of Sydney, Sydney, New South Wales, Australia.

出版信息

Australas J Ageing. 2019 Sep;38 Suppl 2:9-25. doi: 10.1111/ajag.12676.

Abstract

OBJECTIVE

To systematically review literature reporting processes, impact and outcomes of medication review and reconciliation in Australian residential aged care facilities (RACFs).

METHODS

PubMed/MEDLINE, EMBASE, CINAHL, Informit Health and grey literature were searched from 1995 to July 2018. Studies reporting outcomes of a stand-alone medication review or reconciliation interventions in Australian RACFs were included.

RESULTS

Thirteen studies investigated medication review, eight of which studied Residential Medication Management Reviews (RMMRs). Five studies reported that medication reviews identified an average of 2.7-3.9 medication-related problems (MRPs) per resident. One study reported medication reviews had no impact on quality of life, hospitalisation or mortality, but was not powered to assess these. Three studies reported general practitioners' acceptance of pharmacists' recommendations to resolve MRPs, ranging between 45 and 84%.

CONCLUSIONS

Medication review may be a useful strategy to identify and prompt resolution of MRPs. However, the impact on clinical and resident-centred outcomes remains unclear.

摘要

目的

系统回顾关于澳大利亚老年护理机构(RACFs)药物审查与核对的流程、影响及结果的文献。

方法

检索1995年至2018年7月期间的PubMed/MEDLINE、EMBASE、CINAHL、Informit Health及灰色文献。纳入报告澳大利亚老年护理机构独立药物审查或核对干预结果的研究。

结果

13项研究调查了药物审查,其中8项研究了住院药物管理审查(RMMRs)。5项研究报告称,药物审查发现每位居民平均存在2.7 - 3.9个与药物相关的问题(MRPs)。1项研究报告称,药物审查对生活质量、住院率或死亡率没有影响,但该研究没有足够的效力来评估这些方面。3项研究报告了全科医生对药剂师解决MRPs建议的接受程度,范围在45%至84%之间。

结论

药物审查可能是识别并促使解决MRPs的有用策略。然而,其对临床和以居民为中心的结果的影响仍不明确。

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