Lamy P P
School of Pharmacy, University of Maryland, Baltimore.
Drugs Aging. 1993 May-Jun;3(3):232-7. doi: 10.2165/00002512-199303030-00004.
Since the introduction of Medicaid and Medicare in the US in 1965, the rate of use of nursing homes by elderly persons has more than doubled. Nursing home care accounts for about 8% of the healthcare budget. The rate of nursing home use by elderly people and the subsequent costs are expected to increase during the 1990s. The elderly nursing home population have a disproportionately high rate of drug consumption; it has been estimated that up to one-third of elderly nursing home residents receive 8 to 12 drugs per day. Multiple drug use is a risk factor for morbidity in elderly patients. Recent regulations have tried to rationalise the use of particular classes of drugs in nursing homes, with some success. However, multiple drug use is not necessarily unjustified, given the complex comorbidity seen in some patients. Since the value of many drugs has not been proven in the elderly population, further studies are required to prove the value of drugs used in this patient population in improving function and quality of life. Regular review of total regimens should be undertaken often.
自1965年美国引入医疗补助计划和医疗保险制度以来，老年人入住养老院的使用率增加了一倍多。养老院护理费用约占医疗保健预算的8%。预计在20世纪90年代，老年人入住养老院的使用率及其后续费用还会增加。老年养老院人群的药物消费率高得不成比例；据估计，高达三分之一的老年养老院居民每天服用8至12种药物。多种药物联用是老年患者发病的一个风险因素。最近的规定试图使养老院中特定类别的药物使用合理化，并取得了一些成效。然而，鉴于一些患者存在复杂的合并症，多种药物联用不一定不合理。由于许多药物在老年人群中的价值尚未得到证实，因此需要进一步研究来证明用于该患者群体的药物在改善功能和生活质量方面的价值。应经常对整个用药方案进行定期审查。
