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老年人用药质量与安全:2023年更新

Medication Use Quality and Safety in Older Adults: 2023 Update.

作者信息

Hart Laura A, Vo Su, Hanlon Joseph T, Schmader Kenneth E, Gray Shelly L

机构信息

School of Pharmacy, University of Washington, Seattle, Washington, USA.

Geriatric Research, Education, and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.

出版信息

J Am Geriatr Soc. 2025 Jan 27. doi: 10.1111/jgs.19360.

DOI:10.1111/jgs.19360
PMID:39868607
Abstract

Improving the quality of medication use and medication safety are important priorities for healthcare providers who care for older adults. The objective of this article was to identify four exemplary articles with this focus in 2023. We selected high-quality studies that advanced this field of research. The chosen articles cover domains related to deprescribing/discontinuation, optimizing medication use, medication safety/adverse drug events, and other. The first study was a randomized clinical trial evaluating the efficacy of the patient-centered Shed-MEDS deprescribing intervention among older adults transitioning from the hospital to postacute care facilities (domain: deprescribing/discontinuation). The second study, a retrospective cohort study among Medicare beneficiaries, described the phenomenon of a prescribing cascade relic and evaluated continued potassium use after discontinuation of a loop diuretic (domain: optimizing medication use). The third study was a systematic review and meta-analysis describing the prevalence of drug-drug interactions among community-dwelling older adults (domain: other). Lastly, the fourth study was a retrospective cohort study among Medicare beneficiaries that evaluated concurrent gabapentin and opioid use and risk of mortality (domain: medication safety). Collectively, this review succinctly highlights pertinent topics related to promoting safe use of medications and promotes awareness of optimizing older adults' medication regimens.

摘要

提高用药质量和用药安全性是照顾老年人的医疗服务提供者的重要优先事项。本文的目的是找出2023年聚焦于此的四篇典范文章。我们选择了推动该研究领域发展的高质量研究。所选文章涵盖与减药/停药、优化用药、用药安全/药物不良事件及其他相关的领域。第一项研究是一项随机临床试验,评估以患者为中心的Shed-MEDS减药干预措施在从医院过渡到急性后护理机构的老年人中的疗效(领域:减药/停药)。第二项研究是一项针对医疗保险受益人的回顾性队列研究,描述了处方级联遗留现象,并评估了袢利尿剂停用后钾的持续使用情况(领域:优化用药)。第三项研究是一项系统评价和荟萃分析,描述了社区居住老年人中药物相互作用的发生率(领域:其他)。最后,第四项研究是一项针对医疗保险受益人的回顾性队列研究,评估了加巴喷丁和阿片类药物同时使用的情况以及死亡风险(领域:用药安全)。总体而言,本综述简要突出了与促进安全用药相关的重要主题,并提高了对优化老年人用药方案的认识。

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Medication Use Quality and Safety in Older Adults: 2023 Update.老年人用药质量与安全:2023年更新
J Am Geriatr Soc. 2025 Jan 27. doi: 10.1111/jgs.19360.
2
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Criteria to Report Adverse Drug Withdrawal Events in Clinical Trials: A Systematic Review.临床试验中报告药物撤药不良事件的标准:一项系统评价
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引用本文的文献

1
Advancing drug-drug interactions research: integrating AI-powered prediction, vulnerable populations, and regulatory insights.推进药物相互作用研究:整合人工智能驱动的预测、脆弱人群和监管见解。
Front Pharmacol. 2025 Aug 13;16:1618701. doi: 10.3389/fphar.2025.1618701. eCollection 2025.

本文引用的文献

1
Concurrent Gabapentin and Opioid Use and Risk of Mortality in Medicare Recipients with Non-Cancer Pain.伴有非癌症疼痛的 Medicare 受种者中同时使用加巴喷丁和阿片类药物与死亡率的相关性。
Clin Pharmacol Ther. 2023 Nov;114(5):1050-1057. doi: 10.1002/cpt.3019. Epub 2023 Aug 25.
2
STOPP/START criteria for potentially inappropriate prescribing in older people: version 3.老年人潜在不适当处方的 STOPP/START 标准:第 3 版。
Eur Geriatr Med. 2023 Aug;14(4):625-632. doi: 10.1007/s41999-023-00777-y. Epub 2023 May 31.
3
American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults.
美国老年医学学会 2023 年更新了老年人潜在不适当药物使用的 AGS Beers 标准®。
J Am Geriatr Soc. 2023 Jul;71(7):2052-2081. doi: 10.1111/jgs.18372. Epub 2023 May 4.
4
Deprescribing Medications Among Older Adults From End of Hospitalization Through Postacute Care: A Shed-MEDS Randomized Clinical Trial.从住院结束到康复治疗期间为老年患者减少药物治疗:Shed-MEDS 随机临床试验。
JAMA Intern Med. 2023 Mar 1;183(3):223-231. doi: 10.1001/jamainternmed.2022.6545.
5
Prevalence of Drug-Drug Interactions in Older Community-Dwelling Individuals: A Systematic Review and Meta-analysis.老年人社区居住个体中药物-药物相互作用的流行率:系统评价和荟萃分析。
Drugs Aging. 2023 Feb;40(2):117-134. doi: 10.1007/s40266-022-01001-5. Epub 2023 Jan 24.
6
Assessing Medicines for Use in the Geriatric Population.评估用于老年人群的药物。
Clin Pharmacol Ther. 2023 Mar;113(3):536-540. doi: 10.1002/cpt.2793. Epub 2022 Nov 27.
7
Continued potassium supplementation use following loop diuretic discontinuation in older adults: An evaluation of a prescribing cascade relic.老年人停用袢利尿剂后继续补钾:评估一个处方传递遗留问题。
J Am Geriatr Soc. 2023 Feb;71(2):505-515. doi: 10.1111/jgs.18103. Epub 2022 Oct 26.
8
Sources of medication omissions among hospitalized older adults with polypharmacy.住院老年多药治疗患者药物遗漏的来源。
J Am Geriatr Soc. 2022 Apr;70(4):1180-1189. doi: 10.1111/jgs.17629. Epub 2021 Dec 30.
9
An International Consensus List of Potentially Clinically Significant Drug-Drug Interactions in Older People.老年人中潜在临床显著药物相互作用的国际共识清单。
J Am Med Dir Assoc. 2021 Oct;22(10):2121-2133.e24. doi: 10.1016/j.jamda.2021.03.019. Epub 2021 Apr 24.
10
Impact of deprescribing rounds on discharge prescriptions: an interventional trial.减药查房对出院处方的影响:一项干预性试验。
Int J Clin Pharm. 2019 Feb;41(1):159-166. doi: 10.1007/s11096-018-0753-2. Epub 2018 Nov 27.