Baltz Alan P, Gressler Laura E, Costantino Ryan C, McPherson Mary Lynn
Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, USA.
Am J Hosp Palliat Care. 2020 May;37(5):336-342. doi: 10.1177/1049909119876259. Epub 2019 Sep 17.
Patients admitted to hospice are more vulnerable to age-related physiologic changes, polypharmacy, and inappropriate medication use and monitoring. The objective of this study was to characterize the utilization of nonprescription medications in a hospice population.
This was a retrospective study designed to characterize nonprescription or over-the-counter medication use in hospice patients. Data for this study were provided by Seasons Hospice & Palliative Care, a national hospice organization with licenses to operate in 19 states and collected from January 1 to December 31, 2016. The most frequently utilized nonprescription medications, therapeutic classes, and the frequency of patients with at least 1 claim within a therapeutic class were summarized.
The final study population included 62 639 orders representing 15 164 patients. The average age was 79.31 years with a standard deviation of 13.31 years. The average length of stay was 26.80 days with a standard deviation of 44.14 days. The top 5 most common medications were as follows: acetaminophen (25.15%), bisacodyl (21.69%), senna (8.35%), omeprazole (4.51%), and docusate (4.46%). Approximately 13 714 (29.67%) of patients were exposed to analgesics, 13 469 (29.14%) to laxatives, and 3535 (7.65%) to antacids or antigas medications.
This study highlights numerous opportunities for improvement in the use of nonprescription medications among hospice patients. Reducing the use of nonprescription medications that are ineffective or produce unwanted side effects can contribute to improving the quality of care that patients receive.
入住临终关怀机构的患者更容易受到与年龄相关的生理变化、多种药物联合使用以及不适当的药物使用和监测的影响。本研究的目的是描述临终关怀人群中非处方药的使用情况。
这是一项回顾性研究，旨在描述临终关怀患者中非处方药或非处方药物的使用情况。本研究的数据由四季临终关怀与姑息治疗组织提供，该组织是一家在19个州拥有运营许可证的全国性临终关怀机构，数据收集时间为2016年1月1日至12月31日。总结了最常用的非处方药、治疗类别以及在一个治疗类别中至少有1次用药记录的患者频率。
最终研究人群包括62639份医嘱，代表15164名患者。平均年龄为79.31岁，标准差为13.31岁。平均住院时间为26.80天，标准差为44.14天。最常见的5种药物如下：对乙酰氨基酚（25.15%）、比沙可啶（21.69%）、番泻叶（8.35%）、奥美拉唑（4.51%）和多库酯（4.46%）。约13714名（29.67%）患者使用了镇痛药，13469名（29.14%）使用了泻药，3535名（7.65%）使用了抗酸药或抗胀气药物。
本研究突出了临终关怀患者在非处方药使用方面有许多改进机会。减少使用无效或产生不良副作用的非处方药有助于提高患者接受的护理质量。
