Klein L E, German P S, Levine D M
J Am Geriatr Soc. 1981 Nov;29(11):525-30. doi: 10.1111/j.1532-5415.1981.tb03356.x.
The elderly are widely believed to be predisposed to adverse drug reactions, chiefly because of the large quantities of drugs they consume, combined with the effects of aging on distribution, metabolism, and the patterns of drug usage. These beliefs affect the physician's prescribing behavior. To study the validity of these concepts, the supporting medical literature was reviewed. Existing studies of the rates of adverse drug reactions have several methodologic limitations, including inadequate control for disease severity, the use of calculation denominators which overestimate incidence, and dependence upon definitions of medication error rates which do not adequately reflect the potential for adverse outcome. Further studies are needed for clarification of drug-use patterns and problems among the elderly.
人们普遍认为老年人易发生药物不良反应,主要是因为他们服用大量药物,再加上衰老对药物分布、代谢及用药模式的影响。这些看法影响着医生的处方行为。为研究这些观点的正确性,对相关医学文献进行了综述。现有的药物不良反应发生率研究存在若干方法学上的局限性,包括对疾病严重程度控制不足、使用高估发病率的计算分母,以及依赖不能充分反映不良后果可能性的用药错误率定义。需要进一步研究以阐明老年人的用药模式及问题。