多病老年患者的多药治疗:在一项试点 cRCT 中观察到的患者与全科医生所报告药物之间的一致性。

3区 综合性期刊
Lena Schäfer, Michael Paulitsch, Maria Hanf, Truc Sophia Dinh, Astrid-Alexandra Klein, Sophia Klasing, Hanna Seidling, Karen Voigt, Marjan van den Akker
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引用次数: 0

摘要

多重用药(≥5 种药物)会增加患者和全科医生(GP)报告的药物之间出现差异的风险,从而导致不良后果。这项探索性分析评估了在一项试验性群组随机对照试验(cRCT)中,在纸质患者组合的影响下,患者和全科医生报告的药物之间的一致性。68名年龄在65岁或65岁以上的患者(其中26名为女性)的数据完整,这些患者患有多病、多种药物,并且在过去一年中至少住院治疗过一次。对药物名称和强度水平的一致性进行了评估。采用 Wilcoxon 和 Mann-Whitney U 检验(α = 5%)分析了干预组和对照组(IG/CG)之间的差异以及根据性别分层的两个时间点(间隔六个月)之间的比较。为评估出现差异的原因,分析了活性药物成分(API)和解剖治疗化学物(ATC)组的一致性。基线时,IG 的一致性为 72.1%,CG 为 73.9%。加入所报告的药物强度后,两组的一致性均有所下降(IG 为 66.7%,CG 为 60.0%)。六个月后,IG 的一致性明显下降(-5.4%)。ATC B、C 和 H 组的一致性最高,而 N、R 和 Z 组的一致性最低。由于原料药和相应的 ATC 组别不同,报告的药物存在很大差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Polypharmacy in Older Patients with Multimorbidity: The Agreement Between Patient and General Practitioner-Reported Drugs Observed in a Pilot cRCT.

Polypharmacy (≥5 drugs) increases the risk of discrepancies between patient- and general practitioner (GP)-reported drugs, leading to adverse outcomes. This explorative analysis assesses the agreement between patient- and GP-reported drugs under the influence of a paper-based patient portfolio in a pilot cluster randomized controlled trial (cRCT). Complete data were available for 68 patients aged 65 or older (26 were female), with multimorbidity, polypharmacy, and at least one hospitalization in the past year. Agreement was assessed for drug name and strength level. Differences between the intervention and control group (IG/CG) and comparisons between two time points (six-month interval) stratified according to gender were analyzed using Wilcoxon and Mann-Whitney U tests (α = 5%). To evaluate the reasons for discrepancies, the agreement of active pharmaceutical ingredients (APIs) and anatomical therapeutic chemical (ATC) groups was analyzed. At baseline, the agreement was 72.1% for the IG and 73.9% for the CG. Inclusion of the reported drug strength reduced the agreement in both groups (IG 66.7%, CG 60.0%). Agreement for the IG decreased statistically significantly after six months (-5.4%). ATC groups B, C, and H had the highest agreement, while N, R, and Z had the lowest. Large discrepancies in the drugs reported, due to the APIs and the corresponding ATC group, were observed.

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来源期刊
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期刊介绍: International Journal of Environmental Research and Public Health (IJERPH) (ISSN 1660-4601) is a peer-reviewed scientific journal that publishes original articles, critical reviews, research notes, and short communications in the interdisciplinary area of environmental health sciences and public health. It links several scientific disciplines including biology, biochemistry, biotechnology, cellular and molecular biology, chemistry, computer science, ecology, engineering, epidemiology, genetics, immunology, microbiology, oncology, pathology, pharmacology, and toxicology, in an integrated fashion, to address critical issues related to environmental quality and public health. Therefore, IJERPH focuses on the publication of scientific and technical information on the impacts of natural phenomena and anthropogenic factors on the quality of our environment, the interrelationships between environmental health and the quality of life, as well as the socio-cultural, political, economic, and legal considerations related to environmental stewardship and public health. The 2018 IJERPH Outstanding Reviewer Award has been launched! This award acknowledge those who have generously dedicated their time to review manuscripts submitted to IJERPH. See full details at http://www.mdpi.com/journal/ijerph/awards.
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