Colley C A, Lucas L M
Pharmacy Service, Veterans Affairs Medical Center, Portland, OR 97207.
J Gen Intern Med. 1993 May;8(5):278-83. doi: 10.1007/BF02600099.
Polypharmacy occurs when a medical regimen includes at least one unnecessary medication. Factors that contribute to this problem include: patient characteristics of increasing age, multiple medical problems, therapy expectations, and decisions to self-treat; physician factors such as excessive prescribing; and system problems of multiple providers and lack of a coordinating provider. Complications include increased adverse drug reactions and noncompliance, which can lead to increased hospitalization and associated costs. Polypharmacy can be avoided by patient education and sharing the decisions for making the treatment goals and plan. The medication regimen can be simplified by eliminating pharmacologic duplication, decreasing dosing frequency, and regular review of the drug regimen. The goal should be to prescribe the least complex drug regimen for the patient as possible, while considering the medical problems and symptoms and the cost of therapy.
当药物治疗方案中包含至少一种不必要的药物时，就会出现多重用药的情况。导致这一问题的因素包括：患者年龄增长、多种医疗问题、治疗期望以及自我治疗的决定等患者特征；医生过度开药等医生因素；以及多个医疗服务提供者和缺乏协调医疗服务提供者等系统问题。并发症包括药物不良反应增加和不依从性，这可能导致住院率上升及相关费用增加。通过患者教育以及共同制定治疗目标和计划的决策，可以避免多重用药。通过消除药物重复、减少给药频率以及定期审查药物治疗方案，可以简化药物治疗方案。目标应该是在考虑医疗问题、症状和治疗费用的同时，为患者开出尽可能最简单的药物治疗方案。
