在养老院中发现的老年人药物治疗问题：克罗地亚的经验。
Drug therapy problems identified among older adults placed in a nursing home: the Croatian experience.
机构信息
Community Pharmacy Bjelovar, Bjelovar, Croatia.
University of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb, Croatia.
出版信息
J Int Med Res. 2020 Jun;48(6):300060520928791. doi: 10.1177/0300060520928791.
OBJECTIVE
The aim of this study was to determine the frequency and type of drug therapy problems (DTPs) in older institutionalized adults.
METHOD
We conducted a cross-sectional observational study from February to June 2016 at a 150-bed public nursing home in Croatia, where comprehensive medication management (CMM) services were provided. A rational decision-making process, referred to as the Pharmacotherapy Workup method, was used to classify DTPs.
RESULTS
Data were prospectively collected from 73 residents, among which 71% were age 75 years or older. The median number of prescribed medications per patient was 7 (2-16) and polypharmacy (> 4) was recorded for 54 (74.0%) patients. A total 313 DTPs were identified, with an average of 4.3 ± 2 DTPs per patient. The most frequent DTP was needing additional drug therapy (n = 118; 37.7%), followed by adverse drug reaction (n = 55; 17.6%). Lactulose (14.4%), tramadol (6.7%), and potassium (6.4%) were the medications most frequently related to DTPs.
CONCLUSION
The high prevalence of DTPs identified among older institutionalized adults strongly suggests the need to incorporate new pharmacist-led CMM services within existing institutional care facilities, to improve the care provided to nursing home residents.
目的
本研究旨在确定老年住院患者药物治疗问题（DTP）的发生频率和类型。
方法
我们于 2016 年 2 月至 6 月在克罗地亚的一家 150 张床位的公立养老院进行了一项横断面观察性研究，该养老院提供全面药物管理（CMM）服务。使用药物治疗评估方法（Pharmacotherapy Workup method）这一合理的决策过程对 DTP 进行分类。
结果
前瞻性收集了 73 名居民的数据，其中 71%的年龄在 75 岁或以上。每位患者的平均处方药物数为 7（2-16），54 名（74.0%）患者存在多种药物治疗（>4 种）。共发现 313 个 DTP，平均每个患者 4.3±2 个 DTP。最常见的 DTP 是需要额外的药物治疗（n=118；37.7%），其次是药物不良反应（n=55；17.6%）。乳果糖（14.4%）、曲马多（6.7%）和钾（6.4%）是与 DTP 最相关的药物。
结论
在老年住院患者中发现的 DTP 发生率较高，强烈表明需要在现有的机构护理设施中引入新的由药剂师主导的 CMM 服务，以改善对养老院居民的护理。
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