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社区中同时使用多种药物的患者的药物治疗方案中复杂因素的流行程度和患者评价的相关性。

Prevalence and patient-rated relevance of complexity factors in medication regimens of community-dwelling patients with polypharmacy.

机构信息

Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.

Cooperation Unit Clinical Pharmacy, Heidelberg University Hospital, Heidelberg, Germany.

出版信息

Eur J Clin Pharmacol. 2022 Jul;78(7):1127-1136. doi: 10.1007/s00228-022-03314-1. Epub 2022 Apr 27.

Abstract

PURPOSE

To describe the prevalence of complexity factors in the medication regimens of community-dwelling patients with more than five drugs and to evaluate the relevance of these factors for individual patients.

METHODS

Data were derived from the HIOPP-6 trial, a controlled study conducted in 9 general practices which evaluated an electronic tool to detect and reduce complexity of drug treatment. The prevalence of complexity factors was based on the results of the automated analysis of 139 patients' medication data. The relevance assessment was based on the patients' rating of each factor in an interview (48 patients included for analysis).

RESULTS

A median of 5 (range 0-21) complexity factors per medication regimen were detected and at least one factor was observed in 131 of 139 patients. Almost half of these patients found no complexity factor in their medication regimen relevant.

CONCLUSION

In most medication regimens, complexity factors could be identified automatically, yet less than 15% of factors were indeed relevant for patients as judged by themselves. When assessing complexity of medication regimens, one should especially consider factors that are both particularly frequent and often challenging for patients, such as use of inhalers or tablet splitting.

TRIAL REGISTRATION

The HIOPP-6 trial was registered retrospectively on May 17, 2021, in the German Clinical Trials register under DRKS-ID DRKS00025257.

摘要

目的

描述居住在社区、服用五种以上药物的患者的药物治疗方案中存在的复杂性因素的流行情况,并评估这些因素对个体患者的相关性。

方法

数据来自 HIOPP-6 试验,这是一项在 9 家普通诊所进行的对照研究,评估了一种用于检测和减少药物治疗复杂性的电子工具。复杂性因素的流行率是基于对 139 名患者药物数据的自动分析结果得出的。相关性评估是基于患者在访谈中对每个因素的评分(分析了 48 名患者)。

结果

每个药物治疗方案中检测到中位数为 5(范围 0-21)个复杂性因素,139 名患者中有 131 名患者至少存在一个因素。这些患者中几乎有一半认为其药物治疗方案中没有相关的复杂性因素。

结论

在大多数药物治疗方案中,可以自动识别出复杂性因素,但根据患者自身判断,只有不到 15%的因素确实与患者相关。在评估药物治疗方案的复杂性时,应特别考虑那些既频繁又对患者具有挑战性的因素,例如吸入器或片剂分割的使用。

试验注册

HIOPP-6 试验于 2021 年 5 月 17 日在德国临床试验注册处(DRKS-ID:DRKS00025257)进行了回顾性注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/673d/9184426/7e54bb46fb20/228_2022_3314_Fig1_HTML.jpg

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