Vicary Dianne, Hutchison Colin, Aspden Trudi
Pharmacist, Vicary Pharmacy Services Limited, Napier.
Consultant Nephrologist, Hawke's Bay District Health Board, Hastings.
N Z Med J. 2020 Jul 31;133(1519):12-23.
The objective of this research is to determine community dwelling patients' awareness of temporarily discontinuing medicines during acute illness, and the actions they would undertake when acutely unwell.
Adults taking long-term oral medicines for chronic health conditions completed a four-question self-completion paper-based questionnaire collecting data requiring quantitative analysis. Recruitment occurred in six participating Hawke's Bay community pharmacies during 2017 and 2018.
One hundred and thirty people completed the survey. Seventeen (13%) recalled receiving guidance from a health professional on which medicines to stop during excessive vomiting or diarrhoea. Only three people, however, would stop their medicines. Eighteen percent (17/95) of participants aged 65 years and older were prescribed both a NSAID and either an angiotensin-converting-enzyme inhibitor (ACEi) or angiotensin-II receptor blocker (ARB); five reported receiving advice to withhold medicines. Three participants were prescribed a Triple Whammy combination; none reported being advised to withhold medicines.
A small proportion of the participants recalled receiving guidance to temporarily withhold medicines during acute illness; many indicated the advice would not be followed. The results indicate a degree of acute kidney injury prior (AKI) at-risk prescribing. There are opportunities to empower people to self-manage at-risk medicines during periods of acute illness.
本研究的目的是确定社区居住患者在急性疾病期间停用药物的意识，以及他们在急性不适时会采取的行动。
患有慢性健康状况并长期服用口服药物的成年人完成了一份基于纸质问卷的四个问题的自我填写问卷，收集需要定量分析的数据。2017年至2018年期间，在六个参与研究的霍克湾社区药房进行了招募。
130人完成了调查。17人（13%）回忆起曾接受过医疗专业人员关于在严重呕吐或腹泻时应停用哪些药物的指导。然而，只有三人会停用他们的药物。65岁及以上的参与者中有18%（17/95）同时被开了非甾体抗炎药和血管紧张素转换酶抑制剂（ACEi）或血管紧张素II受体阻滞剂（ARB）；五人报告收到了停药建议。三名参与者被开了“三联药物组合”；没有人报告收到停药建议。
一小部分参与者回忆起在急性疾病期间曾接受过暂时停药的指导；许多人表示不会遵循该建议。结果表明存在一定程度的急性肾损伤（AKI）风险处方。在急性疾病期间，有机会让人们有能力自我管理有风险的药物。
