Kose Eiji, Kishimoto Makoto, Shinonaga Hiroshi, Tanaka Eriko, Nakamichi Mariko, Mizokami Fumihiro, Fujihara Hisato
Department of Pharmacy, Juntendo University Hospital, Tokyo, Japan.
Department of Pharmacy, Kirishima Medical Center, Kagoshima, Japan.
Geriatr Gerontol Int. 2025 Jul;25(7):932-938. doi: 10.1111/ggi.70095. Epub 2025 Jun 5.
This study aimed to determine the effect of a proactive pharmacist intervention on improving activities of daily living (ADLs) in older patients with musculoskeletal disorders and polypharmacy undergoing convalescent rehabilitation.
This multicenter retrospective cohort study included 544 Japanese patients in post-acute rehabilitation units from 126 institutions during October 1-31, 2022. Among newly admitted patients in the convalescent rehabilitation ward, those aged ≥65 years with musculoskeletal disorders at admission and on at least five medications (polypharmacy) were included in the study. Participants were divided into two groups: the proactive pharmacist intervention and non-proactive intervention groups. The primary outcome was Functional Independence Measure (FIM) total gain. The secondary outcome was home discharge.
A total of 544 patients (mean age 82.6 ± 7.5 years; 75.1% women) were included in the final analyses. The primary outcome using pair-matched patients showed that the proactive pharmacist intervention group had a significantly higher FIM-total gain score (P = 0.041) than the non-proactive intervention group. However, home discharge was not significantly different between the two groups (P = 0.06).
Proactive pharmacist intervention significantly improved ADLs in older patients with musculoskeletal disorders and polypharmacy undergoing rehabilitation. Therefore, future interventions for older musculoskeletal patients with polypharmacy should consider deprescribing medications from a rehabilitation pharmacotherapy perspective in addition to combined nutrition and exercise therapy. Geriatr Gerontol Int 2025; 25: 932-938.
本研究旨在确定积极的药剂师干预对改善患有肌肉骨骼疾病且正在进行康复疗养的老年患者的日常生活活动（ADL）的影响，这些患者还存在多重用药情况。
这项多中心回顾性队列研究纳入了2022年10月1日至31日期间来自126家机构的544名在急性后期康复病房的日本患者。在康复疗养病房新入院的患者中，年龄≥65岁、入院时患有肌肉骨骼疾病且至少服用五种药物（多重用药）的患者被纳入研究。参与者被分为两组：积极的药剂师干预组和非积极干预组。主要结局是功能独立性测量（FIM）总分增加。次要结局是出院回家。
最终分析共纳入544例患者（平均年龄82.6±7.5岁；75.1%为女性）。使用配对患者的主要结局显示，积极的药剂师干预组的FIM总分增加得分显著高于非积极干预组（P = 0.041）。然而，两组之间的出院回家情况没有显著差异（P = 0.06）。
积极的药剂师干预显著改善了患有肌肉骨骼疾病且正在进行康复的老年多重用药患者的ADL。因此，未来针对老年肌肉骨骼多重用药患者的干预措施，除了联合营养和运动疗法外，还应从康复药物治疗的角度考虑减少用药。《老年医学与老年病学国际杂志》2025年；25：932 - 938。
