Newton P F, Levinson W, Maslen D
Good Samaritan Hospital and Medical Center, Portland, OR 97210.
J Gen Intern Med. 1994 Mar;9(3):164-7. doi: 10.1007/BF02600035.
A geriatric medication algorithm designed to reduce inappropriate prescribing was tested in a resident outpatient clinic. The medications of patients over 65 years old taking more than three medications (n = 41) were compared pre- and post-algorithm using the paired t-test. Pre-algorithm, the average number of drugs was 5.8 per patient (SD 1.62). Fifteen medications (6.4%) were discontinued, seven were substituted for a less toxic medication, and five were added. Post-algorithm, the average number of drugs was 5.6 (SD 1.69), mean difference 0.3 (SD 0.67), p < 0.025. Drugs discontinued were more likely to be high risk compared with drugs used at baseline; drugs added were less likely to be high risk. In this pilot study, the authors conclude that the algorithm helps resident physicians reduce inappropriate prescribing.
一种旨在减少不适当处方的老年用药算法在住院门诊进行了测试。使用配对t检验对65岁以上服用三种以上药物的患者(n = 41)在算法实施前后的用药情况进行了比较。在算法实施前,每位患者的平均用药数量为5.8种(标准差1.62)。15种药物(6.4%)被停用,7种被替换为毒性较小的药物,5种被添加。算法实施后,平均用药数量为5.6种(标准差1.69),平均差异为0.3(标准差0.67),p < 0.025。与基线使用的药物相比,停用的药物更可能是高风险药物;添加的药物不太可能是高风险药物。在这项初步研究中,作者得出结论,该算法有助于住院医师减少不适当处方。