老年患者多重用药调查及共病管理的临床策略  

Surveying the status of older patients' multiple-drug-using behavior and studying on the clinical strategies of co-morbidity management

作　　者：滕晋[1] 王丹[1] 徐熙[1] 许晋[1] 向露[1] 张维[1] 刘鹏[1] 张同琴 

机构地区：[1]四川省医学科学院.四川省人民医院干部医疗科,四川成都610072

出　　处：《中国卫生事业管理》2015年第9期695-697,共3页Chinese Health Service Management

基　　金：四川省科技厅科技支撑项目"血清小肠脂肪酸结合蛋白(I-FABP)联合血清瓜氨酸测定在危重症患者胃肠功能衰竭诊治中的临床意义及应用"(编号:2015SZ0164)

摘　　要：目的:了解老年住院患者多重用药状况,使临床医生对老年患者多重用药的认识更深入,为改善老年人的不合理用药问题及减少由此导致的药物相关不良事件探索新思路。方法:采用随机抽样的方法选取老年科住院患者388例的口服药物长期医嘱单,统计患者的基本情况、疾病诊断、口服药物服用种类、数量及药物不良反应(ADR)。结果:老年住院患者服用5种及其以上药物者占81.4%。日服药种类≥10种的患者ADR发生率高达47.6%,服药数量≥30粒的ADR发生率高达82.8%,服药品种及数量与药物不良反应呈正相关,诊断数目与服药品种及数量呈正相关。结论:多重用药广泛存在于老年患者中,老年患者多重用药易出现药物不良反应,医护人员、患者及家属应提高对多重用药的认识,针对老年患者的共病制定个体化、合理的治疗策略,减少药物不良反应,改善其功能状态和生活质量。Objective：To study the status of older patients＇ multiple-drug-using behavior, and provide references for improving their rational drug-using and reducing drug-related adverse events. Methods ：The long term medical orders of medicines for 388 ca- ses of randomly sampled elderly inpatients were studied in some aspects of baseline information, diagnosis, kinds and amount of o- ral medications and adverse drug reaction （ADR）. Results ：81.4% of these elderly inpatients had taken more than 5 kinds of med- ications. The incidence of ADR among inpatients who took more than 10 kinds of oral medications and over 30 pills each day reached 47.6% and 82.8%, respectively. The kinds and amount of medications were positively related with ADR. Conclusion： Most of elderly patients had multiple-drug-using behaviors, which can result in ADR. It is suggested to improve the medical pro- fessionals, patients and their families＇ knowledge, and develop individual and reasonable treatment strategies to reduce ADR and improve their quality of life.

关 键 词：老年患者 多重用药 药物不良反应 共病 

分 类 号：R95[医药卫生—药学]