老年人的多药治疗、不适当处方和撤药：从性别视角看。

Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens.

机构信息

Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Department of Medicine and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.

Section of Geriatrics, Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.

出版信息

Lancet Healthy Longev. 2021 May;2(5):e290-e300. doi: 10.1016/S2666-7568(21)00054-4.

DOI:10.1016/S2666-7568(21)00054-4

PMID:36098136

Abstract

Polypharmacy is very common in older adults and increases the risk of inappropriate and unsafe prescribing for older adults. Older adults, particularly women (who make up the majority of this age group), are at the greatest risk for drug-related harm. Therefore, optimising drug prescribing for older people is very important. Identifying potentially inappropriate medications and opportunities for judicious deprescribing processes are intrinsically linked, complementary, and essential for optimising medication safety. This Review focuses on optimising prescribing for older adults by reducing doses or stopping drugs that are potentially harmful or that are no longer needed. We explore how sex (biological) and gender (sociocultural) factors are important considerations in safe drug prescribing. We conclude by providing a practical approach to optimising medication safety that clinicians can routinely apply to the care of their older patients, highlighting how sex and gender considerations inform medication decision making.

摘要

老年人普遍存在多种用药情况，这增加了为老年人开具不适当和不安全处方的风险。老年人，尤其是女性（占该年龄组的大多数），面临着与药物相关伤害的最大风险。因此，优化老年人的药物处方非常重要。确定潜在不适当的药物和明智的减药机会，这两者本质上是相互关联、相辅相成的，对于优化药物安全性至关重要。本综述重点关注通过减少剂量或停止潜在有害或不再需要的药物来优化老年人的处方。我们探讨了性别（生物学）和性别（社会文化）因素如何成为安全药物处方的重要考虑因素。最后，我们提供了一种优化药物安全性的实用方法，临床医生可以常规应用于老年患者的护理，强调了性别考虑因素如何影响药物决策。