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优化固体口服剂型在吞咽困难患者中的给药方式:综合评价。

Optimization of solid oral dosage form administration to patients with swallowing difficulties: An integrative review.

机构信息

Post-Graduate Program in Pharmaceutical Assistance, Federal University of Paraná, Jardim Botânico, Curitiba, PR, Brazil.

Pharmaceutical Sciences Department, State University of Ponta Grossa, Uvaranas, Ponta Grossa, PR, Brazil.

出版信息

J Adv Nurs. 2024 Apr;80(4):1335-1354. doi: 10.1111/jan.15910. Epub 2023 Oct 31.

Abstract

AIM

To appraise and synthesize research investigating optimizing the administration of solid oral dosage forms (SODFs) to adults with swallowing difficulties.

DESIGN

An integrative review.

METHODS

An electronic search was conducted on Medical Literature Analysis and Retrieval System Online (Public Medline interface), Elsevier SciVerse Scopus and Scientific Electronic Library Online (updated February 2023). Restriction regarding the publication date was not considered for the inclusion of records. Studies addressing risks, general aspects, recommendations about patient postural adjustments, swallowing techniques, swallowing aids and aspects of concealment of SODFs were included.

RESULTS

Fifty-three records published between 2002 and 2021 were included. The main administration risks were aspiration, asphyxia and solid oral dosage form-induced oral/oesophageal mucosal lesions. The most frequent general aspect reported was administering one oral dosage form at a time. The sitting position was the most patient postural adjustment mentioned. The most frequently reported solid oral dosage form swallowing technique was the lean-forward method for capsules. Solid oral dosage form swallowing aids cited: tongue and throat lubricant and solid oral dosage form coating device, swallowing cup and swallowing straw.

CONCLUSION

The literature data on administering SODFs for adults with swallowing difficulties were appraised and synthesized. Some aspects, for example, not administering SODFs simultaneously, can make swallowing safer. Postural adjustments and solid oral dosage form swallowing aids are important to avoid administration risks. Swallowing SODFs can be easier if learned by techniques. Liquid and food are helpful as vehicles, and several of these have been listed.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: By optimizing the contributing factors of administering oral pharmacotherapy, the nurse can use appropriate practices to improve patient safety. Additionally, knowing and establishing the administration aspects are reasonable steps for standardizing care for patients with swallowing oral dosage form difficulties.

IMPACT

This study addressed administering SODFs to adult patients with swallowing difficulties. The administration of SODFs to adult patients with swallowing difficulties can be optimized if only one oral dosage form at a time is administrated and if patient postural adjustments, swallowing techniques and swallowing aids are used. This investigation will impact the care of patients with swallowing difficulties.

REPORTING METHOD

The authors declare they adhered to the relevant EQUATOR guidelines and report following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

摘要

目的

评价和综合研究,以优化吞咽困难成人的固体口服剂型(SODF)管理。

设计

综合审查。

方法

在 Medical Literature Analysis and Retrieval System Online(Public Medline 界面)、Elsevier SciVerse Scopus 和 Scientific Electronic Library Online 上进行电子检索(更新至 2023 年 2 月)。对于纳入的记录,不考虑出版日期的限制。包括关于风险、一般方面、患者姿势调整、吞咽技术、吞咽辅助工具和 SODF 隐蔽性方面的建议的研究。

结果

共纳入 2002 年至 2021 年期间发表的 53 篇记录。主要给药风险为吸入、窒息和 SODF 引起的口腔/食管黏膜损伤。报告的最常见一般方面是一次给予一种口服剂型。提到的最常见的患者姿势调整是坐姿。报告的最常见的 SODF 吞咽技术是胶囊的前倾法。引用的 SODF 吞咽辅助工具:舌和喉润滑剂和 SODF 包衣设备、吞咽杯和吞咽吸管。

结论

对成人吞咽困难患者 SODF 给药的文献数据进行了评价和综合。一些方面,例如,不同时给予 SODF,可以使吞咽更安全。姿势调整和 SODF 吞咽辅助工具对于避免给药风险很重要。如果学会了技术,吞咽 SODF 可能会更容易。液体和食物作为载体很有帮助,并且已经列出了其中的一些。

对专业人员和/或患者护理的影响:通过优化口服药物治疗给药的影响因素,护士可以使用适当的实践来提高患者的安全性。此外,了解和建立给药方面是为吞咽 SODF 困难的患者规范护理的合理步骤。

影响

本研究探讨了成人吞咽困难患者 SODF 的给药。如果一次仅给予一种口服剂型,并且使用患者姿势调整、吞咽技术和吞咽辅助工具,那么优化成人吞咽困难患者 SODF 的给药可以得到优化。该研究将影响吞咽困难患者的护理。

报告方法

作者声明他们遵守了相关的 EQUATOR 指南,并按照系统评价和荟萃分析的 Preferred Reporting Items(PRISMA)2020 声明报告。

患者或公众的贡献

没有患者或公众的贡献。

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