评估衰弱老年患者在急诊科的药物相关问题：老年护理团队中以药剂师为主导的药物审查。
Assessment of drug-related problems at the emergency department in older patients living with frailty: pharmacist-led medication reviews within a geriatric care team.
机构信息
Department of Clinical Pharmacy, Tergooi Medical Center, Van Riebeeckweg 212, 1213 XZ, Hilversum, the Netherlands.
Department of Geriatrics, Tergooi MC, Hilversum, the Netherlands.
出版信息
BMC Geriatr. 2023 Apr 5;23(1):215. doi: 10.1186/s12877-023-03942-x.
BACKGROUND
Older patients are vulnerable to experiencing drug related problems (DRPs), which may result in emergency department (ED) visits. However, it is not standard practice to conduct medications reviews during ED visit. The aim of this study was to assess the number of DRPs in older patients living with frailty at the ED, identified through pharmacist-led medication reviews within a geriatric care team, and to determine the acceptance rate of pharmacists' recommendations among hospital physicians and general practitioners or elderly care specialists.
METHODS
A retrospective observational study was performed in patients ≥ 70 years living with frailty at the ED at Tergooi Medical Center. Pharmacist-led medication reviews were conducted to identify and classify DRPs as part of a larger geriatric assessment. The acceptance rate of given recommendations was determined during follow-up.
RESULTS
A total of 356 ED visits were included. The mean (standard deviation, SD) age of patients was 83 (6.8) years. About 76% of patients had at least one DRP. In total, 548 DRPs were identified with a mean of 1.5 DRP (SD 1.3) per patient. The acceptance rate of medication recommendations in admitted patients was 55%, and 32% among general practitioners/elderly care specialists in discharged patients.
CONCLUSIONS
Pharmacist-led medication reviews as part of a geriatric care team identified DRPs in 76% of older patients living with frailty at the ED. The acceptance rate was substantially higher in admitted patients compared to discharged patients.
背景
老年患者易发生药物相关问题（DRP），可能导致其前往急诊部（ED）就诊。然而，ED 就诊期间进行药物审查并非标准做法。本研究旨在评估在 ED 接受治疗的衰弱老年患者中，通过药剂师主导的药物审查发现的 DRP 数量，并确定医院医生、全科医生或老年护理专家对药剂师建议的接受率。
方法
在 Tergooi 医疗中心，对 ED 中患有衰弱症的≥70 岁患者进行了一项回顾性观察研究。药剂师主导的药物审查旨在识别和分类 DRP，这是更大规模的老年评估的一部分。在随访期间确定了给定建议的接受率。
结果
共纳入 356 例 ED 就诊。患者的平均（标准差，SD）年龄为 83（6.8）岁。约 76%的患者至少存在一种 DRP。总共发现了 548 种 DRP，每位患者平均存在 1.5 种 DRP（SD 1.3）。接受住院患者药物建议的比例为 55%，而接受出院患者的全科医生/老年护理专家的比例为 32%。
结论
作为老年护理团队的一部分，药剂师主导的药物审查在 ED 接受治疗的衰弱老年患者中发现了 76%的 DRP。与出院患者相比，住院患者的接受率明显更高。
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