Research Unit for Inland Development, Polytechnic of Guarda, Guarda, Portugal.
Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal.
Clin Ther. 2020 Apr;42(4):559-572.e14. doi: 10.1016/j.clinthera.2020.02.005. Epub 2020 Mar 5.
The complex combination of medicines associated with age-related physiological alterations leads older adults to experience drug-related problems (DRPs). The goal of this study was to review the frequency and type of DRPs and DRP risk factors in home-dwelling older adults.
A MEDLINE PubMed and EMBASE scientific databases search was performed. Articles published from January 2000 through December 2018 reporting DRPs in home-dwelling older adults were included.
From 668 articles screened, 13 met the inclusion criteria and were included in this study. Overall, the studies included 8935 home-dwelling patients. The mean number of DRPs per patient observed was 4.16 (1.37-10). The main causes of DRPs were "drug selection" (51.41%), "dose selection" (11.62%), and "patient related" (10.70%) problems. The drug classes more frequently associated with DRPs were "cardiovascular system," "alimentary tract and metabolism," and "nervous system," and they represented 32.1%, 29.4%, and 16.5% of all drug selection problems, respectively. Respiratory system medicines accounted for 6.65% of all DRPs, of which "patient related" problems accounted for 97.28%.
Despite the heterogeneity of methodology of the included studies and the heterogeneity of tools used to identify DRPs, this analysis clearly shows the high prevalence of DRPs in home-dwelling older adults and highlights the need for interventions to improve medicine use in this population. This work also provides useful information for the development of strategies to improve medication use in home-dwelling older adults.
与年龄相关的生理变化相关的药物的复杂组合导致老年人出现药物相关问题（DRPs）。本研究的目的是回顾居家老年人的 DRP 发生频率、类型和 DRP 危险因素。
对 MEDLINE PubMed 和 EMBASE 科学数据库进行了检索。纳入了 2000 年 1 月至 2018 年 12 月期间发表的报告居家老年人 DRP 的文章。
从筛选出的 668 篇文章中，有 13 篇符合纳入标准并纳入本研究。总体而言，这些研究共纳入了 8935 名居家患者。观察到每位患者的平均 DRP 数为 4.16（1.37-10）。DRP 的主要原因是“药物选择”（51.41%）、“剂量选择”（11.62%）和“患者相关”（10.70%）问题。与 DRP 更相关的药物类别是“心血管系统”、“消化道和代谢”和“神经系统”，分别占所有药物选择问题的 32.1%、29.4%和 16.5%。呼吸系统药物占所有 DRP 的 6.65%，其中“患者相关”问题占 97.28%。
尽管纳入研究的方法学存在异质性，且用于确定 DRP 的工具也存在异质性，但本分析清楚地表明，居家老年人的 DRP 发生率很高，突出了需要采取干预措施来改善该人群的药物使用。这项工作还为制定改善居家老年人用药策略提供了有用信息。
