Department of Pharmacy, University of Oslo, Blindern, Box 1068, 0316, Oslo, Norway.
Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsö, Norway.
Int J Clin Pharm. 2019 Dec;41(6):1516-1525. doi: 10.1007/s11096-019-00914-3. Epub 2019 Nov 15.
Background Patients with intellectual disabilities is an underserved patient group that have poor abilities to express their health complaints. Objective The aim of this study was to improve pharmacotherapy in patients with intellectual disability, by the use of medication reviews and interdisciplinary case conferences. Setting Patients with intellectual disabilities receiving home care services in Oslo, Norway. Method Patients receiving home care services were recruited by a nurse. A clinical pharmacist conducted medication reviews, and thereafter, the patients' general practitioner, nurse/social educator and clinical pharmacist discussed the pharmacotherapy at an interdisciplinary case conference. Patient demographics, prescribed drugs (strength, dose, indication) and drug-related problems (DRPs) were recorded. Main outcome measure Patient outcomes and actions taken to resolve DRPs 6 weeks after the case conference. Results Forty patients (34-77 years) with intellectual disabilities consented to medication reviews. They used on average 12 different drugs (range 5-23). The most commonly prescribed drugs were CNS-active drugs: analgesics (25 patients), antiepileptics (23 patients) and anxiolytics (21 patients). In total, 27 patients used between 3 and 7 different CNS-active drugs. The clinical pharmacist identified 178 DRPs in 39/40 patients (average 4.5 DRPs, range 0-13). DRPs for 30% of all prescribed drugs were resolved (145/481). Overall, 11% of drugs were deprescribed, 8% required therapeutic monitoring/follow-up, and either the dosage, formulation or route of administration were changed for 7% of the drugs. Conclusions Patients with intellectual disabilities receiving home care services were prescribed many unnecessary drugs and needed adjustment of pharmacotherapy for about one third of their prescribed drugs. The interdisciplinary case conferences improved pharmacotherapy for this vulnerable patient group.
智力残疾患者是一个服务不足的患者群体，他们表达健康诉求的能力较差。
本研究旨在通过药物审查和跨学科病例会议来改善智力残疾患者的药物治疗。
挪威奥斯陆接受家庭护理服务的智力残疾患者。
通过护士招募接受家庭护理服务的患者。临床药师进行药物审查，然后患者的全科医生、护士/社会教育者和临床药师在跨学科病例会议上讨论药物治疗。记录患者的人口统计学数据、处方药物（强度、剂量、适应证）和药物相关问题（DRP）。
病例会议后 6 周的患者结局和解决 DRP 所采取的措施。
40 名（34-77 岁）智力残疾患者同意进行药物审查。他们平均使用 12 种不同的药物（范围 5-23）。最常开的药物是中枢神经系统活性药物：止痛药（25 名患者）、抗癫痫药（23 名患者）和抗焦虑药（21 名患者）。总共有 27 名患者使用了 3 到 7 种不同的中枢神经系统活性药物。临床药师在 39/40 名患者（平均 4.5 个 DRP，范围 0-13）中发现了 178 个 DRP。解决了 30%（145/481）的所有处方药物的 DRP。总的来说，11%的药物被减少使用，8%需要治疗监测/随访，7%的药物的剂量、剂型或给药途径发生了变化。
接受家庭护理服务的智力残疾患者开了许多不必要的药物，约三分之一的处方药物需要调整药物治疗。跨学科病例会议改善了这个弱势群体的药物治疗。
