Ooi Kazuya
Laboratory of Clinical Pharmacology, Department of Pharmaceutical Sciences, Suzuka University of Medical Science.
Nihon Ronen Igakkai Zasshi. 2019;56(4):498-503. doi: 10.3143/geriatrics.56.498.
In order to ensure that patients use medicines and dressings properly, the pharmacist must understand a patient's medication history, symptoms, and test results. This information helps pharmacists to apply their technical knowledge to the prescription of drugs. In Japan, more than a quarter of the population is over 65 years of age; the country is heading toward a "super-aged" society. It is common for older patients to have more than one disease. Improved healthcare has resulted in easier access to medications. Consequently, the problem of polypharmacy has emerged. In this study, we examined the effect of a pharmacist-led intervention on polypharmacy.
The study subjects were patients of 65 years of age or older who had visited a pharmacist for a consultation between September 2019 and November 2019. The pharmaceutical consultation content and number of proposals were recorded, and the percentage of prescriptions modified and the percentage of patients who experienced changes in symptoms at 4 weeks after the consultation were calculated.
Three hundred sixty-one patients underwent pharmaceutical consultation. Most patients were 80 years of age or older. For 349 patients (96.7%), the consultation resulted in a prescription change. Before the consultation, the average number of drugs was 7.2. After intervention, this decreased by 1.2 to an average of 6.0 drugs. In addition, polypharmacy with≥6 drugs dropped sharply from 67.3% of patients before the consultation to 53.7% of patients after the consultation. The full pharmacotherapy guidelines in 2015 suggested that 33.7% of drugs require particularly careful dosing. Changes in symptoms at 4 weeks after the pharmacist's consultation occurred in 84.5% of patients.
The results of this study suggest that pharmacists should review the prescriptions of elderly patients. We conducted an active intervention for cases of polypharmacy and observed a decrease in the number of drugs following prescription consultation. Furthermore, a reduction in medicines was suggested on the basis of physical checks and test values. Blood test results allow pharmacists to improve the quality of their advice.
为确保患者正确使用药物和敷料，药剂师必须了解患者的用药史、症状和检查结果。这些信息有助于药剂师将其专业知识应用于药物处方。在日本，超过四分之一的人口年龄在65岁以上；该国正朝着“超老龄化”社会发展。老年患者通常患有一种以上疾病。医疗保健的改善使人们更容易获得药物。因此，多重用药问题出现了。在本研究中，我们考察了药剂师主导的干预措施对多重用药的影响。
研究对象为2019年9月至2019年11月期间因咨询而拜访药剂师的65岁及以上患者。记录药学咨询内容和建议数量，并计算咨询后4周处方修改的百分比以及症状出现变化的患者百分比。
361名患者接受了药学咨询。大多数患者年龄在80岁及以上。对于349名患者（96.7%），咨询导致了处方改变。咨询前，平均用药数量为7.2种。干预后，这一数字减少了1.2种，平均为6.0种。此外，使用≥6种药物的多重用药情况从咨询前患者的67.3%大幅降至咨询后患者的53.7%。2015年的完整药物治疗指南表明，33.7%的药物需要特别谨慎地给药。药剂师咨询后4周，84.5%的患者症状出现了变化。
本研究结果表明，药剂师应审查老年患者的处方。我们对多重用药情况进行了积极干预，发现处方咨询后用药数量有所减少。此外，根据身体检查和检查值建议减少用药。血液检查结果使药剂师能够提高其建议的质量。
