Department of Pharmacy, Teikyo University School of Medicine University Hospital, Tokyo, Japan.
Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan.
Geriatr Gerontol Int. 2020 Jul;20(7):655-663. doi: 10.1111/ggi.13975.
Many patients in rehabilitation facilities are affected by polypharmacy. Polypharmacy is associated with rehabilitation outcomes and functional recovery. Consequently, a combination of rehabilitation and pharmacotherapy may improve the outcomes of older people undergoing rehabilitation. A recent report described the concept of rehabilitation pharmacotherapy. The concept envisages helping frail older people and people with disabilities to achieve the highest possible body function, activity level and quality of life. There are two key tenets of rehabilitation pharmacotherapy: "pharmacotherapy in consideration of rehabilitation" and "rehabilitation in consideration of pharmacotherapy." "Pharmacotherapy in consideration of rehabilitation" includes use of drugs to treat impairment, activity limitation and participation restriction based on the International Classification of Functioning, Disability, and Health. "Rehabilitation in consideration of pharmacotherapy" refers to tailoring of rehabilitation considering the content of pharmacotherapy. With respect to drugs and motor dysfunction, anticholinergic drugs are associated with dysphagia and fractures. Increased use of potentially inappropriate medications may adversely affect the nutritional status. With respect to activities of daily living, polypharmacy and use of potentially inappropriate medications negatively affect the improvement in motor function during rehabilitation. Potent anticholinergic drugs are more likely to impede the improvement in cognitive function. In this review, we address the concept of rehabilitation pharmacotherapy and discuss its importance from the perspective of polypharmacy, the effect of drugs on disability and disease, nutritional status and activities of daily living. Geriatr Gerontol Int 2020; 20: -.
许多康复机构的患者都受到多药治疗的影响。多药治疗与康复结果和功能恢复有关。因此，将康复与药物治疗相结合可能会改善正在接受康复的老年人的预后。最近的一份报告描述了康复药物治疗的概念。该概念设想帮助体弱老年人和残疾人士实现尽可能高的身体功能、活动水平和生活质量。康复药物治疗有两个关键原则：“考虑康复的药物治疗”和“考虑药物治疗的康复”。“考虑康复的药物治疗”包括根据《国际功能、残疾和健康分类》，使用药物治疗功能障碍、活动受限和参与受限。“考虑药物治疗的康复”是指根据药物治疗的内容来调整康复。在药物和运动功能障碍方面，抗胆碱能药物与吞咽困难和骨折有关。潜在不适当药物的使用增加可能会对营养状况产生不利影响。在日常生活活动方面，多药治疗和潜在不适当药物的使用会对康复过程中运动功能的改善产生负面影响。强效抗胆碱能药物更有可能阻碍认知功能的改善。在这篇综述中，我们探讨了康复药物治疗的概念，并从多药治疗、药物对残疾和疾病的影响、营养状况和日常生活活动的角度讨论了其重要性。《老年医学与老年病学国际》2020 年;20: -。
