摘要
目的应用Beers标准及药物适宜性指数（MAD对老年共病患者多重用药进行评估及干预，探讨通过全程药事指导提高用药安全性、合理性的可行性。方法本组191例老年共病患者。入组时，依据Beers标准及MAI进行评估，然后由临床药师和老年病科医师根据有效性、安全性、适用性的原则共同制定新的药物治疗方案，患者病情好转出院，以后每月到老年综合评估门诊随诊，6个月后再次评估，取得研究数据。结果干预前后比较，存在潜在不适当用药的患者从98例（51．31％）下降到21例（10．99％），差异具有统计学意义（χ2=65．154，P〈0．05）；MAI平均值从6．35±5．25下降到0．75±1．81，下降了88．19％，差异具有统计学意义（Z=-10．549，P〈0．05）。结论临床药师全程药事指导，应用Beers标准及MAI从主客观两方面进行评估并干预，可以极大地提高老年共病患者的用药安全性、合理性。
Objective To evaluate and intervene polypharmacy in multimorbid elderly patients in order to explore the application effects and reliability of Beers criteria and medication appropriateness index （MAD and improve the safety, rationality and feasibility of drug use through the whole process of pharmaceutical directions. Methods This study included 191 patients with muttimorbidity. Based on the Beers criteria and MAI, enrolled elderly patients with multimorbidity were evaluated and intervened. Moreover, based on the efficacy, safety and suitability, clinical pharmacists and geriatricians made new medication strategy,and undertook a follow up study every month after discharge. After six months, all patients were evaluated again. All data were recorded before and 6-months after intervention. Results After versus before intervention,the potentially inappropriate polypharmacy was decreased [ 21 cases （10.99% ） vs. 98 cases （51.31 % ）,χ2 = 65. 154, P〈0.05 ] in multimorbid elderly patients. Moreover, the MAI score was significantly decreased after the intervention（6.35± 5.25 to 0.75% 1.81,Z= - 10.549,P〈0.05）. Conclusions Through the whole process of pharmaceutical directions of clinical pharmacists, the Beers Criteria- and MAI-based assessnient and intervention could improve the safety,rationality and efficiency of drug therapy in multimorbid elderly patients.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2018年第1期57-61,共5页
Chinese Journal of Geriatrics
基金
大连市科技计划项目（2014E14SF153）
