Wolfson Centre for Personalised Medicine, University of Liverpool, Liverpool, UK
Wolfson Centre for Personalised Medicine, University of Liverpool, Liverpool, UK.
Drug Ther Bull. 2023 Jun;61(6):87-91. doi: 10.1136/dtb.2022.000050. Epub 2023 May 16.
Living with multiple long-term health conditions (multimorbidity) is increasingly common in older age. The more long-term conditions that an individual has, the more medicines they are likely to take. Hospitalisation as a consequence of medication-related harm is increasing and a concerted effort is needed to reduce the burden of harm caused by medication. However, making decisions about the balance between benefit and harm for an older person with multimorbidity and polypharmacy is very complex. There are various clinical tools that can help to identify patients at higher risk of harm and numerous strategies, including medicines optimisation reviews that incorporate personalised health information, to try to reduce risk. Further education and training of the healthcare professionals is needed to equip the multidisciplinary workforce with the skills and knowledge to address these challenges. This article discusses some of the changes that can be implemented now and highlights areas that will require more research before they can be introduced, in order to help patients to get the best out of their medicines.
患有多种长期健康状况(多种疾病)在老年人群中越来越常见。一个人患有的长期疾病越多,他们可能服用的药物就越多。由于药物相关伤害而住院的情况正在增加,因此需要共同努力来减轻药物伤害带来的负担。然而,对于患有多种疾病和多种药物的老年人来说,要在获益和伤害之间做出平衡决策非常复杂。有各种临床工具可以帮助识别有更高伤害风险的患者,还有许多策略,包括药物优化审查,这些策略都包含个性化健康信息,以尝试降低风险。需要进一步对医疗保健专业人员进行教育和培训,以使多学科工作人员具备技能和知识,以应对这些挑战。本文讨论了现在可以实施的一些变革,并强调了在引入之前需要更多研究的领域,以便帮助患者从药物中获得最大收益。