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使用 FORTA(适合老年人)分类评估老年帕金森病患者的药物安全性概况:一项单中心回顾性分析的结果。

Drug safety profiles in geriatric patients with Parkinson's disease using the FORTA (Fit fOR The Aged) classification: results from a mono-centric retrospective analysis.

机构信息

Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.

Centre for Information Management (ZIMT), Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.

出版信息

J Neural Transm (Vienna). 2021 Jan;128(1):49-60. doi: 10.1007/s00702-020-02276-x. Epub 2020 Dec 1.

DOI:10.1007/s00702-020-02276-x
PMID:33263172
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7815558/
Abstract

To reduce potentially inappropriate medications, the FORTA (Fit fOR The Aged) concept classifies drugs in terms of their suitability for geriatric patients with different labels, namely A (indispensable), B (beneficial), C (questionable), and D (avoid). The aims of our study were to assess the medication appropriateness in PD inpatients applying the FORTA list and drug-drug interaction software, further to assess the adequacy of FORTA list for patients with PD. We retrospectively collected demographic data, comorbidities, laboratory values, and the medication from the discharge letters of 123 geriatric inpatients with PD at the university hospital of Hannover Medical School. Patients suffered on average from 8.2 comorbidities. The majority of the medication was labeled A (60.6% of PD-specific and 40.9% of other medication) or B (22.3% of PD-specific and 26.9% of other medication). Administered drugs labeled with D were amantadine, clozapine, oxazepam, lorazepam, amitriptyline, and clonidine. Overall, 545 interactions were identified, thereof 11.9% severe interactions, and 1.7% contraindicated combinations. 81.3% of patients had at least one moderate or severe interaction. The FORTA list gives rational recommendations for PD-specific and other medication, especially for general practitioners. Considering the demographic characteristics and the common multimorbidity of geriatric PD patients, this study underlines the importance of awareness, education, and preventive interventions to increase drug safety.

摘要

为了减少潜在的不适当用药,FORTA(适合老年人的药物)概念根据药物对不同标签的老年患者的适用性进行分类,即 A(必不可少)、B(有益)、C(可疑)和 D(避免)。我们研究的目的是应用 FORTA 清单和药物相互作用软件评估 PD 住院患者的药物适宜性,进一步评估 FORTA 清单对 PD 患者的适宜性。我们回顾性地收集了汉诺威医学院大学医院 123 例老年 PD 住院患者的出院记录中的人口统计学数据、合并症、实验室值和药物信息。患者平均患有 8.2 种合并症。大多数药物被标记为 A(60.6%的 PD 特异性药物和 40.9%的其他药物)或 B(22.3%的 PD 特异性药物和 26.9%的其他药物)。被标记为 D 的药物有金刚烷胺、氯氮平、奥沙西泮、劳拉西泮、阿米替林和可乐定。总共发现了 545 种相互作用,其中 11.9%为严重相互作用,1.7%为禁忌组合。81.3%的患者至少有一种中度或严重的相互作用。FORTA 清单为 PD 特异性药物和其他药物提供了合理的建议,特别是对全科医生。考虑到老年 PD 患者的人口统计学特征和常见的多种合并症,本研究强调了提高药物安全性的意识、教育和预防干预的重要性。

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Potential drug interactions in drug therapy prescribed for older adults at hospital discharge: cross-sectional study.老年人出院时药物治疗中的潜在药物相互作用:横断面研究
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Impact of the Anticholinergic Burden on Disease-Specific Symptoms in Parkinsonian Syndromes.抗胆碱能负担对帕金森综合征特定疾病症状的影响。
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Update on treatments for nonmotor symptoms of Parkinson's disease-an evidence-based medicine review.帕金森病非运动症状治疗的研究进展——基于循证医学的评价
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Gerontology. 2019;65(3):216-228. doi: 10.1159/000492572. Epub 2018 Sep 10.
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Nervenarzt. 2019 Feb;90(2):167-174. doi: 10.1007/s00115-018-0590-5.
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Mov Disord. 2018 Aug;33(8):1248-1266. doi: 10.1002/mds.27372. Epub 2018 Mar 23.