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老年心力衰竭患者的多重用药:老年医学专家和药剂师的作用

Polypharmacy in Older People With Heart Failure: Roles of the Geriatrician and Pharmacist.

作者信息

Stefil Maria, Dixon Matthew, Bahar Jameela, Saied Schabnam, Mashida Knievel, Heron Olivia, Shantsila Eduard, Walker Lauren, Akpan Asangaedem, Lip Gregory Yh, Sankaranarayanan Rajiv

机构信息

Liverpool Centre for Cardiovascular Science, University of Liverpool Liverpool, UK.

Department of Cardiology, Liverpool University Hospitals NHS Foundation Trust Liverpool, UK.

出版信息

Card Fail Rev. 2022 Dec 19;8:e34. doi: 10.15420/cfr.2022.14. eCollection 2022 Jan.

Abstract

Heart failure (HF) is a common health condition that typically affects older adults. Many people with HF are cared for on an inpatient basis, by noncardiologists, such as acute medical physicians, geriatricians and other physicians. Treatment options for HF are ever increasing, and adherence to guidelines for prognostic therapy contributes to polypharmacy, which is very familiar to clinicians who care for older people. This article explores the recent trials in both HF with reduced ejection fraction and HF with preserved ejection fraction and the limitations of international guidance in their management with respect to older people. In addition, this article discusses the challenge of managing polypharmacy in those with advanced age, and the importance of involving a geriatrician and pharmacist in the HF multidisciplinary team to provide a holistic and person-centred approach to optimisation of HF therapies.

摘要

心力衰竭(HF)是一种常见的健康状况,通常影响老年人。许多心力衰竭患者由非心脏病专家在住院基础上进行护理,如急性内科医生、老年病医生和其他医生。心力衰竭的治疗选择不断增加,遵循预后治疗指南会导致多重用药,这对于照顾老年人的临床医生来说非常熟悉。本文探讨了近期射血分数降低的心力衰竭和射血分数保留的心力衰竭试验,以及国际指南在老年人管理方面的局限性。此外,本文还讨论了管理高龄患者多重用药的挑战,以及在心力衰竭多学科团队中纳入老年病医生和药剂师以提供全面和以患者为中心的方法来优化心力衰竭治疗的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b05/9987511/d565f6d7911a/cfr-08-e34-g001.jpg

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