Zhang Sha, Zhu Deqiu, Qi Zhan, Tian Lulu, Qian Shijing, Song Danfei, Chen Beilei, Tong Shanshan, Wang Jing, Wu Juan
J Am Pharm Assoc (2003). 2022 Mar-Apr;62(2):481-486. doi: 10.1016/j.japh.2021.10.023. Epub 2021 Oct 26.
There is a lack of research on the nature of drug-related problems (DRPs) in older adult communities in China and the impact of home medication review on DRP reduction and health-related quality-of-life (HRQoL) improvement.
To identify and categorize DRPs in older adults in China and to assess the impact of home medication review.
The prospective study was conducted in 2 community health service centers in Shanghai, China from December 2018 to December 2019. Eligible patients received a home medication review by a clinical pharmacist to assess for DRPs and adherence, propose pharmaceutical interventions, and measure outcomes of HRQoL. All enrolled patients were followed up for 3 months.
Medication use in 412 patients was analyzed. A total of 362 DRPs were identified, an average of 0.88 per patient. Treatment effectiveness was the primary DRP type (249; 68.8%). The most common causes of DRPs were patient-related (35.1%) and drug selection (31.0%). Pharmacists made 733 interventions, an average of 2 per DRP. A total of 82.1% of these interventions were accepted. At a 3-month follow-up, home medication review led to a statistically significant reduction in the mean number of DRPs (0.4 vs. 0.88, P < 0.001) and an increase in medication adherence (1.42 vs. 0.85, P < 0.001). Both HRQoL indicators also improved, EuroQol 5 Dimension scale (0.75 vs. 0.78, P < 0.001) and EuroQol-visual analog scale (70 vs. 77.65, P < 0.001).
Home medication review is a practical means to optimize drug therapy and improve patients' HRQoL in community settings.
中国老年人群体中与药物相关问题（DRPs）的本质，以及居家用药评估对减少DRPs和改善健康相关生活质量（HRQoL）的影响，目前缺乏相关研究。
识别并分类中国老年人中的DRPs，并评估居家用药评估的影响。
这项前瞻性研究于2018年12月至2019年12月在中国上海的2家社区卫生服务中心进行。符合条件的患者接受了临床药师的居家用药评估，以评估DRPs和依从性，提出药物干预措施，并测量HRQoL结果。所有入组患者均随访3个月。
分析了412例患者的用药情况。共识别出362个DRPs，平均每位患者0.88个。治疗效果是主要的DRP类型（249个；68.8%）。DRPs最常见的原因是患者相关因素（35.1%）和药物选择（31.0%）。药师进行了733次干预，平均每个DRP 2次。这些干预措施中共有82.1%被接受。在3个月的随访中，居家用药评估导致DRPs的平均数量有统计学意义的减少（0.4对0.88，P<0.001），用药依从性增加（1.42对0.85，P<0.001）。两个HRQoL指标也有所改善，欧洲五维健康量表（0.75对0.78，P<0.001）和欧洲视觉模拟量表（70对77.65，P<0.001）。
居家用药评估是在社区环境中优化药物治疗和改善患者HRQoL的一种实用手段。
