多用药指南:评估药物审查目标人群的规模,并用常规数据描述其潜在药物安全问题的频率

V. Lappe, T. Dinh, S. Harder, Maria-Sophie Brueckle, J. Fessler, U. Marschall, C. Muth, I. Schubert
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引用次数: 5

摘要

(1) 背景:大约10年前,发布了几项关于更好地管理多药患者的指南。一个核心问题是目标群体的定义。因此,本研究的主要目的是应用德国指南的标准来评估目标群体的规模。另一个目的是描述目标群体患者药物安全问题的发生频率。(2) 方法:本研究基于德国一家大型法定健康保险公司(n=9012523)的管理数据。(3) 结果:14.1%的参保患者,即近130万人,符合多发病(至少三种慢性病)和在至少91天内同时使用五种或五种以上药物的标准。大约5%的多发病和多药人群至少满足了五分之三的额外场合相关标准。药物安全问题经常发生:潜在药物不足、QT药物、苯二氮卓类或Z类药物以及质子泵抑制剂的治疗发生率分别为30.4%、28.9%、11.1%和52.4%。(4) 结论:该分析显示了有资格进行结构化药物审查的患者的范围,并证明了基于药物治疗安全问题潜在风险的高百分比的咨询的相关性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Multimedication Guidelines: Assessment of the Size of the Target Group for Medication Review and Description of the Frequency of Their Potential Drug Safety Problems with Routine Data
(1) Background: About 10 years ago, several guidelines for the better management of patients with polypharmacy were issued. A central issue is the definition of the target group. The primary aim of this study is therefore to assess the size of the target group, applying the criteria of the German guidelines. A further aim is to describe the frequency of occurrence of medication safety issues for patients of the target group. (2) Methods: The study is based on administrative data of one large statutory health insurer in Germany (n = 9,012,523). (3) Results: The criteria of multimorbidity (at least three chronic diseases) and utilization of five or more concurrent drugs over at least 91 days is fulfilled by 14.1% of the insured patients, or almost 1.3 million persons. About 5% of this multimorbid and poly-medicated population fulfilled at least three of out of five additional occasion-related criteria. Medication safety issues occur frequently: treatment prevalence with potentially inadequate medication, QT-drugs, benzodiazepine or Z-drugs and proton pump inhibitors was 30.4%, 28.9%, 11.1% and 52.4%, respectively. (4) Conclusions: The analysis shows the scope of patients eligible for a structured medication review and demonstrates the relevance for counselling based on the high percentage potentially at risk due to medication therapy safety problems.
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