Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
New England Geriatrics Research Education and Clinical Center and Geriatrics and Extended Care, VA Boston Healthcare System, and Brigham and Women's Hospital, 150 South Huntington #182, Boston, MA, 02130, USA.
Drugs Aging. 2023 May;40(5):391-396. doi: 10.1007/s40266-023-01016-6. Epub 2023 Apr 12.
Polypharmacy is a common problem among older adults, as they are more likely to have multiple chronic conditions and may experience fragmentation of care among specialists. The Geriatrics 5Ms framework offers a person-centered approach to address polypharmacy and optimize medications, including deprescribing when appropriate. The elements of the Geriatrics 5Ms, which align with the approach of the Age-Friendly Health Systems initiative, include consideration of Medications, Mind, Mobility, Multicomplexity, and What Matters Most. Each M domain impacts and is impacted by medications, and learning about the patient's goals through questions guided by the Geriatrics 5Ms may inform an Age-Friendly medication optimization plan. While research on the implementation of each of the elements of the Geriatrics 5Ms shows benefit, further research is needed to study the impact of this framework in clinical practice.
老年人普遍存在多种用药问题,因为他们更容易患有多种慢性疾病,并且可能会在专科医生之间经历治疗的碎片化。老年医学 5Ms 框架提供了一种以患者为中心的方法来解决多种用药问题,并优化药物治疗,包括在适当情况下减少用药。老年医学 5Ms 的要素与老年友善健康照护系统倡议的方法一致,包括考虑药物、思维、活动能力、多重复杂性和最重要的事情。每个 M 领域都会影响和被药物治疗影响,通过老年医学 5Ms 指导的问题了解患者的目标,可以为老年友善的药物优化计划提供信息。虽然关于老年医学 5Ms 的每个要素的实施的研究都表明有获益,但需要进一步的研究来研究该框架在临床实践中的影响。