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老年人群中与药物相关的问题及其干预:文献综述

Medication-Related Problems and Their Intervention in the Geriatric Population: A Review of the Literature.

作者信息

Falemban Alaa H

机构信息

Department of Pharmacology and Toxicology, Umm Al-Qura University, Makkah, SAU.

出版信息

Cureus. 2023 Sep 2;15(9):e44594. doi: 10.7759/cureus.44594. eCollection 2023 Sep.

Abstract

In order to implement the principles of providing clinically and economically effective care, the current state of healthcare must be evaluated, and challenges must be addressed. As part of a physician's role in such a context, one tool consists of identifying medication-related problems (MRPs) and accordingly implementing best practices and innovative strategies to improve patient healthcare outcomes. The geriatric population is expected to have passed through the natural ageing process and experienced several physiological and biological changes that impact their bodies and lives. In the presence of geriatric syndromes and the increased number of medications consumed, the risk of MRPs such as polypharmacy, potentially inappropriate medication (PIM), adverse events, drug-drug interactions, and risk of non-adherence increases. Different interventions that focus on practical and perceptual barriers have been studied, and different tools to define clinically important prescribing problems relating to PIM have been established. The Beers Criteria and STOPP (Screening Tool of Older Persons' Prescriptions)/START (Screening Tool to Alert to Right Treatment) criteria are the most widely used sets of explicit PIM criteria; however, they are still limited in Saudi Arabia. These tools should be considered in clinical settings to improve healthcare outcomes in the geriatric population, and the clinical relevance of enhancing medication should also be explored from the point of view of both the patient and healthcare practitioners.

摘要

为了贯彻提供临床和经济有效护理的原则,必须评估当前的医疗保健状况,并应对各种挑战。作为医生在这种情况下的职责的一部分,一种方法是识别与药物相关的问题(MRP),并据此实施最佳实践和创新策略,以改善患者的医疗保健结果。老年人群预计已经经历了自然衰老过程,并经历了一些影响其身体和生活的生理和生物学变化。在存在老年综合征和用药数量增加的情况下,多药合用、潜在不适当用药(PIM)、不良事件、药物相互作用以及不依从风险等MRP的风险会增加。已经研究了针对实际和认知障碍的不同干预措施,并建立了不同的工具来定义与PIM相关的临床重要处方问题。《比尔斯标准》和STOPP(老年人处方筛查工具)/START(正确治疗警报筛查工具)标准是最广泛使用的明确PIM标准集;然而,它们在沙特阿拉伯仍然有限。在临床环境中应考虑使用这些工具,以改善老年人群的医疗保健结果,还应从患者和医疗从业者的角度探讨加强药物治疗的临床相关性。

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Specific features of rational pharmacotherapy in elderly patients.老年患者合理药物治疗的特点。
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