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基层医疗中老年人的用药问题:文献综述叙述

Medication use problems among older adults at a primary care: A narrative of literature review.

作者信息

Christopher Christina, Kc Bhuvan, Shrestha Sunil, Blebil Ali Qais, Alex Deepa, Mohamed Ibrahim Mohamed Izham, Ismail Norhasimah

机构信息

School of Pharmacy Monash University Malaysia Subang Jaya Malaysia.

Jeffrey Cheah School of Medicine and Health Sciences Monash University Malaysia Subang Jaya Malaysia.

出版信息

Aging Med (Milton). 2022 Mar 15;5(2):126-137. doi: 10.1002/agm2.12203. eCollection 2022 Jun.

Abstract

Appropriate medication use is one of the most significant challenges among the older population. Although medication use problems are well documented at the secondary and tertiary health care level, the evidence at the primary care level of OECD region is limited. A narrative review of existing literature was conducted through a nonsystematic search for original articles through electronic search databases, Ovid Medline, Google Scholar from 2001 to 2021, and a combination of citation references. Medication use problems are prevalent in older adults at the primary care level. The main issues of medication use identified were as follows; nonadherence, adverse drug events, accessibility, polypharmacy, inappropriate medications, belief about medications, lack of knowledge and awareness, and lack of deprescribing. In addition, the current review has identified the possibilities of the problems: many medications, forgetfulness, lack of deprescribing, lack of communication, poor understanding, and limited awareness of inappropriate medications. This review found that various medication use problems subclusters were identified to impact the health care need among older adults. Therefore, effective interventions targeting these issues need to be developed to reduce medication use problems among older adults at a primary care level.

摘要

合理用药是老年人群面临的最重大挑战之一。尽管在二级和三级医疗保健层面,用药问题已有充分记录,但经合组织地区初级保健层面的相关证据有限。通过对2001年至2021年期间的原始文章进行非系统性检索,利用电子搜索数据库(Ovid Medline、谷歌学术)并结合引用参考文献,对现有文献进行了叙述性综述。在初级保健层面,用药问题在老年人中普遍存在。已确定的用药主要问题如下:不依从、药物不良事件、可及性、多重用药、不适当用药、对药物的认知、知识和意识缺乏以及缺乏减药。此外,本次综述还确定了这些问题产生的可能性:药物种类繁多、健忘、缺乏减药、缺乏沟通、理解不足以及对不适当用药的认识有限。本综述发现,已识别出各种用药问题子集群,它们会影响老年人的医疗保健需求。因此,需要制定针对这些问题的有效干预措施,以减少初级保健层面老年人的用药问题。

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