慢性肾脏病中的多种药物治疗：健康结局与基于药学的策略来减轻不适当的多种药物治疗。
Polypharmacy in chronic kidney disease: Health outcomes & pharmacy-based strategies to mitigate inappropriate polypharmacy.
机构信息
College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA; Department of Medicine, Louisiana State University Health Sciences Center School of Medicine, New Orleans, LA, USA; Department of Pharmacy, University Medical Center New Orleans, New Orleans, LA, USA.
College of Pharmacy, Xavier University of Louisiana, New Orleans, LA, USA; East Jefferson General Hospital-Family Medicine Clinic, Metairie, LA, USA.
出版信息
Am J Med Sci. 2024 Jan;367(1):4-13. doi: 10.1016/j.amjms.2023.10.003. Epub 2023 Oct 12.
The rising prevalence of comorbidities in an increasingly aging population has sparked a reciprocal rise in polypharmacy. Patients with chronic kidney disease (CKD) have a greater burden of polypharmacy due to the comorbidities and complications associated with their disease. Polypharmacy in CKD patients has been linked to myriad direct and indirect costs for patients and the society at large. Pharmacists are uniquely positioned within the healthcare team to streamline polypharmacy management in the setting of CKD. In this article, we review the landscape of polypharmacy and examine its impacts through the lens of the ECHO model of Economic, Clinical, and Humanistic Outcomes. We also present strategies for healthcare teams to improve polypharmacy care through comprehensive medication management process that includes medication reconciliation during transitions of care, medication therapy management, and deprescribing. These pharmacist-led interventions have the potential to mitigate adverse outcomes associated with polypharmacy in CKD.
由于与疾病相关的合并症和并发症，患有慢性肾脏病（CKD）的患者的药物治疗负担更重。CKD 患者的药物治疗与患者和整个社会的众多直接和间接成本有关。药剂师在医疗团队中具有独特的地位，可以在 CKD 环境中简化药物治疗管理。在本文中，我们回顾了药物治疗的现状，并通过 ECHO 模型（经济、临床和人文结果）的视角来检查其影响。我们还介绍了医疗团队通过全面药物管理流程改善药物治疗的策略，该流程包括在护理过渡期间进行药物重整、药物治疗管理和药物减量。这些由药剂师主导的干预措施有可能减轻 CKD 患者药物治疗相关的不良后果。
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