Gosney M, Tallis R
Lancet. 1984 Sep 8;2(8402):564-7. doi: 10.1016/s0140-6736(84)90775-x.
573 elderly patients admitted to the general medical and geriatric beds of a teaching hospital in January, 1983, were receiving an average of 2.14 drugs on admission, 5.48 during inpatient stay, and 3.47 on discharge. Contraindicated or adversely interacting drugs were identified in 200 (3.2%) of 6160 prescriptions. 136 (23.7%) patients were affected. 7 patients received drugs to which they had had adverse reactions. There were a further 60 contraindicated and 133 adversely interacting drugs. 117 prescriptions were potentially hazardous and another 27 interactions may have led to suboptimal treatment. 131 (65.6%) undesirable prescriptions were deemed avoidable and a further 36 (18%) were probably so. The frequency of errors was higher in admission medication (5.3%) than in hospital prescriptions (2.9%). The importance, origin, and prevention of prescribing errors in drug-induced morbidity in the elderly are discussed.
1983年1月,一家教学医院普通内科和老年病科收治的573名老年患者入院时平均用药2.14种,住院期间平均用药5.48种,出院时平均用药3.47种。在6160张处方中,有200张(3.2%)存在禁忌或不良相互作用的药物。136名(23.7%)患者受到影响。7名患者使用了曾使其出现不良反应的药物。此外还有60种禁忌药物和133种存在不良相互作用的药物。117张处方有潜在风险,另有27种相互作用可能导致治疗效果欠佳。131张(65.6%)不良处方被认为是可以避免的,另有36张(18%)可能也是如此。入院用药时的错误发生率(5.3%)高于住院期间处方的错误发生率(2.9%)。本文讨论了老年人药物性发病中处方错误的重要性、根源及预防措施。