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心血管疾病患者潜在不适当药物使用的趋势和关注点。

Trends and concerns of potentially inappropriate medication use in patients with cardiovascular diseases.

机构信息

Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Russian Federation.

出版信息

Expert Opin Drug Saf. 2021 Oct;20(10):1191-1206. doi: 10.1080/14740338.2021.1928632. Epub 2021 May 17.

DOI:10.1080/14740338.2021.1928632
PMID:33970732
Abstract

: The use of potentially inappropriate medications (PIM) is an alarming social risk factor in cardiovascular patients. PIM administration may result in iatrogenic disorders and adverse consequences may be attenuated by limiting PIM intake.: The goal of this review article is to discuss the trends, risks, and concerns regarding PIM administration with focus on cardiovascular patients. To find data, we searched literature using electronic databases (Pubmed/Medline 1966-2021 and Web of Science 1975-2021). The data search terms were cardiovascular diseases, potentially inappropriate medication, potentially harmful drug-drug combination, potentially harmful drug-disease combination, drug interaction, deprescribing, and electronic health record.: Drugs for heart diseases are the most commonly prescribed medications in older individuals. Despite the availability of explicit and implicit PIM criteria, the incidence of PIM use in cardiovascular patients remains high ranging from 7 to 85% in different patient categories. Physician-induced disorders often occur when PIM is administered and adverse effects may be reduced by limiting PIM intake. Main strategies promising for addressing PIM use include deprescribing, implementation of systematic electronic records, pharmacist medication review, and collaboration among cardiologists, internists, geriatricians, clinical pharmacologists, pharmacists, and other healthcare professionals as basis of multidisciplinary assessment teams.

摘要

: 潜在不适当药物(PIM)的使用是心血管病患者的一个令人震惊的社会风险因素。PIM 的给药可能导致医源性疾病,通过限制 PIM 的摄入可以减轻不良后果。: 本文综述的目的是讨论心血管病患者中 PIM 给药的趋势、风险和关注点。为了查找数据,我们使用电子数据库(Pubmed/Medline 1966-2021 和 Web of Science 1975-2021)搜索文献。数据搜索词为心血管疾病、潜在不适当药物、潜在有害药物-药物组合、潜在有害药物-疾病组合、药物相互作用、停药和电子健康记录。: 心脏病药物是老年人最常开的药物。尽管有明确和隐含的 PIM 标准,但心血管病患者中 PIM 的使用发生率仍然很高,不同患者类别中的发生率为 7%至 85%。当给予 PIM 时,往往会发生医生引起的疾病,通过限制 PIM 的摄入可以减少不良反应。解决 PIM 使用问题的主要策略包括停药、实施系统的电子记录、药剂师药物审查以及心脏病专家、内科医生、老年病学家、临床药理学家、药剂师和其他医疗保健专业人员之间的合作,作为多学科评估团队的基础。

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