Plein Center for Geriatric Pharmacy Research, Education and Outreach, School of Pharmacy, University of Washington, Seattle, Washington, USA.
Department of Medicine (Geriatrics), School of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
J Am Geriatr Soc. 2022 Feb;70(2):389-397. doi: 10.1111/jgs.17603. Epub 2021 Dec 13.
Improving the quality of medication use and medication safety are important priorities for prescribers who care for older adults. The objective of this article was to identify four exemplary articles with this focus in 2020. We selected high-quality studies that moved the field of research forward and were not merely replication studies. The chosen articles cover domains related to deprescribing, medication safety, and optimizing medication use. The first study, a noninferiority randomized clinical trial in England, evaluated whether antihypertensive medication reduction is possible without significant changes in systolic blood pressure control or adverse events over the 12-week follow-up (domain: deprescribing). The second study, a prospective cohort study of women at Kaiser Permanente Southern, California, examined the association between bisphosphonate use and atypical femur fracture (domain: medication safety). The third study examined the effectiveness and safety of a multifaceted antimicrobial stewardship and quality improvement initiative in reducing unnecessary antimicrobial use for unlikely cystitis cases in noncatheterized residents in 25 nursing homes across the United States (domain: optimizing medication use). Lastly, the fourth study, a population-based cohort study in the United Kingdom, examined the association of tramadol use with risk of hip fracture (domain: medication safety). Collectively, this review succinctly highlights pertinent topics related to promoting safe use of medications and promotes awareness of optimizing older adults' medication regimens.
提高用药质量和用药安全是照顾老年人的医生的重要优先事项。本文的目的是在 2020 年确定四篇具有这一重点的典范文章。我们选择了高质量的研究,这些研究推动了研究领域的发展,而不仅仅是复制研究。所选文章涵盖了与撤药、用药安全和优化用药相关的领域。第一项研究是在英国进行的一项非劣效性随机临床试验,评估了在 12 周的随访期间,是否可以在不显著改变收缩压控制或不良事件的情况下减少抗高血压药物(领域:撤药)。第二项研究是加利福尼亚州凯撒永久南方的一项前瞻性队列研究,调查了双膦酸盐的使用与非典型股骨骨折之间的关系(领域:用药安全)。第三项研究在美国 25 家养老院的非导尿居民中,考察了多方面的抗菌药物管理和质量改进措施在减少不太可能发生膀胱炎的情况下不必要使用抗菌药物的有效性和安全性(领域:优化用药)。最后,第四项研究是英国的一项基于人群的队列研究,调查了曲马多的使用与髋部骨折风险之间的关系(领域:用药安全)。总的来说,这篇综述简洁地突出了与促进安全用药相关的相关主题,并提高了对优化老年人用药方案的认识。
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