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优化癌症合并多种疾病患者的药物治疗:减药案例。

Optimising Medications for Patients With Cancer and Multimorbidity: The Case for Deprescribing.

机构信息

Faculté de Médicine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche de L'Institut Universitaire de Gériatrie de Montréal, Québec, Canada; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia.

School of Pharmacy, University of East Anglia, Norwich, UK.

出版信息

Clin Oncol (R Coll Radiol). 2020 Sep;32(9):609-617. doi: 10.1016/j.clon.2020.05.015. Epub 2020 Jun 17.

Abstract

The majority of patients diagnosed with cancer are aged over 65 years and have two or more chronic conditions in addition to cancer and the risk of chronic conditions increases further after cancer. The presence of multimorbidity adds complexity to care, as patients' goals of care and the focus of treatment can change with a diagnosis of cancer. Multimorbidity is frequently associated with polypharmacy, the use of potentially inappropriate medications, the presence of adverse drug reactions and potential drug-drug interactions: all of which impact on health outcomes and the cost of care. Consequently, it is vital that a systematic approach is taken to regularly review cancer patients' medication regimens to ensure that they support an optimal balance of benefits with acceptable levels of harm. Several patient and clinician resources are presented to guide the process of medication review and deprescribing.

摘要

大多数被诊断患有癌症的患者年龄在 65 岁以上,除了癌症之外还有两种或两种以上的慢性疾病,并且癌症后慢性疾病的风险进一步增加。合并症的存在增加了护理的复杂性,因为患者的护理目标和治疗重点可能会随着癌症的诊断而改变。合并症常与多种药物治疗相关,即使用潜在不适当的药物,存在药物不良反应和潜在的药物相互作用:所有这些都会影响健康结果和护理成本。因此,必须采取系统的方法定期审查癌症患者的药物治疗方案,以确保它们在可接受的伤害水平下支持最佳的获益平衡。目前有多种患者和临床医生资源可用于指导药物审查和减药过程。

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