J Am Pharm Assoc (2003). 2021 Jan-Feb;61(1):e16-e18. doi: 10.1016/j.japh.2020.08.038. Epub 2020 Sep 12.
Using central nervous system (CNS)-active medications increases older adults' risk for falls and fall-related injuries. Opioids and benzodiazepines are among the most widely used CNS-active medications and because of their addictive potential and widespread use for common ailments such as chronic pain, anxiety, or sleep, are also among the most difficult to deprescribe. Reducing the dose burden of these 2 medication classes in older adults-to balance safety with efficacy-is a challenge that requires persistence and strategic support structures to be successful. We propose a novel care model that uses the support of targeted consultant pharmacist services to help primary care providers reduce the unnecessary use of opioids and benzodiazepines in their patients who are older adults. This care model holds promise to not only offer providers additional time-saving clinical support but to help their practices improve patient outcomes, such as a reduction in medication-related falls and excess opioid use.
使用作用于中枢神经系统(CNS)的药物会增加老年人跌倒和与跌倒相关伤害的风险。阿片类药物和苯二氮䓬类药物是最广泛使用的作用于中枢神经系统的药物之一,由于它们具有成瘾性,并且广泛用于常见疾病,如慢性疼痛、焦虑或睡眠,因此也最难减药。减少这 2 类药物在老年人中的剂量负担——在安全性和疗效之间取得平衡——是一项需要坚持不懈和战略支持结构才能成功的挑战。我们提出了一种新颖的护理模式,利用目标顾问药剂师服务的支持,帮助初级保健提供者减少老年患者中不必要的阿片类药物和苯二氮䓬类药物的使用。这种护理模式不仅有望为提供者提供额外的节省时间的临床支持,还有助于改善他们的实践效果,例如减少与药物相关的跌倒和过量使用阿片类药物。