Silva-Almodóvar Armando, Nahata Milap C
Institute of Therapeutic Innovations and Outcomes (ITIO), College of Pharmacy, Ohio State University, Columbus, OH 43210, USA.
Tabula Rasa HealthCare, Tucson, AZ 85701, USA.
Pharmaceuticals (Basel). 2022 May 28;15(6):681. doi: 10.3390/ph15060681.
The management of multiple chronic health conditions often requires patients to be exposed to polypharmacy to improve their health and enhance their quality of life. However, exposure to polypharmacy has been associated with an increased risk for adverse effects, drug-drug interactions, inappropriate prescribing, medication nonadherence, increased healthcare utilization such as emergency department visits and hospitalizations, and costs. Medication-based risk scores have been utilized to identify patients who may benefit from deprescribing interventions and reduce rates of inappropriate prescribing. These risk scores may also be utilized to prompt targeted discussions between patients and providers regarding medications or medication classes contributing to an individual's risk for harm, eventually leading to the deprescribing of the offending medication(s). This opinion will describe existing medication-based risk scores in the literature, their utility in identifying patients at risk for specific adverse events, and how they may be incorporated in healthcare settings to reduce rates of potentially inappropriate polypharmacy and avoidable healthcare utilization and costs.
多种慢性健康状况的管理通常要求患者接受多种药物治疗，以改善健康状况并提高生活质量。然而，接受多种药物治疗与不良反应、药物相互作用、不适当处方、用药依从性差、急诊就诊和住院等医疗保健利用率增加以及成本增加的风险相关。基于药物的风险评分已被用于识别可能从减药干预中获益的患者，并降低不适当处方的发生率。这些风险评分还可用于促使患者和医疗服务提供者就导致个体伤害风险的药物或药物类别进行有针对性的讨论，最终导致停用有问题的药物。本观点将描述文献中现有的基于药物的风险评分、它们在识别特定不良事件风险患者方面的效用，以及如何将它们纳入医疗保健环境中，以降低潜在不适当的多药治疗率以及避免不必要的医疗保健利用和成本。
