老年精神疾病住院患者多重用药现状与合理使用的探讨  

Prevalence and rational use of polypharmacy in elderly patients in psychiatric hospitals:a review and discussion

作　　者：牛梦溪 刘珊珊[1,2] 庄红艳[1,2] 臧彦楠[1,2] 鲍爽 贾菲 李鹏飞 张庆娥 Niu Mengxi;Liu Shanshan;Zhuang Hongyan;Zang Yannan;Bao Shuang;Jia Fei;Li Pengfei;Zhang Qinge(The National Clinical Research Center for Mental Disorders&Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京安定医院、国家精神疾病医学中心、国家精神心理疾病临床医学研究中心、精神疾病诊断与治疗北京市重点实验室,北京100088 [2]首都医科大学人脑保护高精尖创新中心,北京100069

出　　处：《中华老年医学杂志》2025年第2期149-155,共7页Chinese Journal of Geriatrics

基　　金：首都卫生发展科研专项(首发2020-1-2031);北京市医院管理中心扬帆计划。

摘　　要：在人口老龄化的背景下,老年精神疾病患者的多重用药问题愈发凸显。这些患者因认知功能衰退和抑郁情绪,更易面临用药风险,且常常因躯体疾病控制不佳使得治疗更为复杂。针对这些挑战,本文提出了一系列管理策略,重点强调了药师在药物审查中的主导作用,全面评估药物的风险、效益以及患者的依从性。本文提倡要深入考量患者的临床需要和个人偏好,强调多学科团队协作的重要性,通过有效沟通达成用药共识。同时,合理运用临床决策支持系统作为辅助工具,以提高用药决策的科学性。此外,药师通过科学规范的方法精简用药方案,并鼓励患者或家属积极参与自我管理,从而提升患者对治疗调整的接受度和依从性。In the context of aging population,the issue of polypharmacy among elderly patients with mental disorders has become increasingly prominent.Cognitive decline and depressive symptoms render these patients more vulnerable to medication-related risks,while poorly managed physical illnesses further complicate their treatment.To address these challenges,this paper proposes a series of management strategies that emphasize the critical role of pharmacists in conducting medication reviews.A comprehensive assessment of drug risks,benefits,and patient adherence is essential.The proposed strategies not only require careful consideration of patients'clinical needs and individual preferences but also highlight the importance of multidisciplinary team collaboration to reach a consensus on medication therapy.The use of clinical decision support systems as an auxiliary tool is recommended to enhance the scientific rigor of medication decision-making.Furthermore,pharmacists can optimize medication regimens through scientifically validated methods and promote patient or family involvement in self-management to improve acceptance and adherence to treatment adjustments.

关 键 词：多种药物疗法 精神障碍 药物疗法 药物相互作用 住院患者 

分 类 号：R749[医药卫生—神经病学与精神病学]