Yang Hsiu-Wu, Yu Ching-Hsiang, Huang Teng-Yi, Huang Chia-Hui, Su Yu-Jang
Emergency Department, Toxicology Division, MacKay Memorial Hospital, Taipei, Taiwan.
Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
Medicine (Baltimore). 2025 Mar 7;104(10):e41590. doi: 10.1097/MD.0000000000041590.
Polypharmacy, the use of multiple medications, is a prevalent issue globally that contributes to increased healthcare costs and places additional burdens on patients' organs. This study aims to deprescribe and prevent polypharmacy in the emergency department. We conducted a retrospective review of randomly selected medical records from the Internal Medicine Department of Taipei MacKay Emergency Department, spanning from August 1, 2023, to October 31, 2023. For cases identified as involving polypharmacy, pharmacists provided medication education using the Team Resource Management Polypharmacy Interview Guide, while social workers contacted patients via phone to recommend follow-up visits for deprescribing. Patients experiencing polypharmacy were significantly older than those on appropriate medication regimens (79.8 vs 67.3 years, P = .002). After deprescribing interventions, the average number of medications for polypharmacy patients was 5.9 higher than for those receiving appropriate prescriptions (9.2 vs 3.3, P = .001). The most common conditions associated with polypharmacy were diabetes mellitus, hypertension, and arrhythmia. Polypharmacy poses a significant medication management challenge, with affected patients taking an average of 6.9 more medications than those on appropriate treatment regimens. The resource management module of our team successfully reduced the incidence of polypharmacy by 8.4% in the emergency department.
多重用药,即使用多种药物,是一个全球性的普遍问题,它会导致医疗成本增加,并给患者的器官带来额外负担。本研究旨在减少急诊科的多重用药现象并预防其发生。我们对台北马偕医院急诊科内科从2023年8月1日至2023年10月31日随机抽取的病历进行了回顾性研究。对于确定为涉及多重用药的病例,药剂师使用团队资源管理多重用药访谈指南提供用药教育,而社会工作者则通过电话联系患者,建议其进行减药随访。经历多重用药的患者明显比采用适当用药方案的患者年龄大(79.8岁对67.3岁,P = 0.002)。在进行减药干预后,多重用药患者的平均用药数量比接受适当处方的患者多5.9种(9.2种对3.3种,P = 0.001)。与多重用药相关的最常见病症是糖尿病、高血压和心律失常。多重用药带来了重大的药物管理挑战,受影响患者的平均用药数量比采用适当治疗方案的患者多6.9种。我们团队的资源管理模块成功将急诊科的多重用药发生率降低了8.4%。