多药:定义,对结果的影响,需要纠正

IF 0.3 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
S. Martsevich, N. Kutishenko, Y. Lukina, O. Drapkina
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引用次数: 0

摘要

这篇评论专门讨论了一个现代的多药问题。这一概念尚未形成一个普遍的定义和明确的标准,但认为这是至少5种药物(M)的处方。本文讨论了多药的频率和主要原因,并论证了其与年龄的明确关系。超重和肥胖、多病、低体力活动、脆弱明显与多重用药相关。认知障碍、残疾、长期疼痛综合征和恶性疾病也易导致多重用药。缺少长期主治医生、住在养老院、咨询多名专家、医疗记录管理不善,这些都与综合药房有关。据信,多种用药会导致以下一系列不良后果:它增加了跌倒的风险、M的副作用、住院甚至死亡。其主要原因是M之间发生了各种不良相互作用,包括不可预测的相互作用,但这些现象与多药的因果关系并不总是得到证实。研究复方药物对处方治疗的依从性并不是一件容易的事情,迄今为止,复方药物是否影响药物治疗的依从性这个问题还没有明确的答案。文章详细介绍了可能存在的不合理处方问题,探讨了预防和打击多药的主要方法。显然,最可接受的方法是取消对患者没有指征或禁忌症的药物,以及开那些有直接指征但患者没有接受的药物。患者的治疗应尽可能个体化,考虑到与病程特点、预后、患者的生活方式、身体和精神状态有关的许多因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Polypharmacy: definition, impact on outcomes, need for correction
The review is devoted to a modern problem of polypharmacy. A universal definition and clear criteria for this concept have not yet been formed, but it is believed that this is the prescribing of at least 5 medications (M). The article discusses the frequency and main causes of polypharmacy, demonstrates its clear relationship with the age. The presence of overweight and obesity, multimorbidity, low physical activity, fragility are clearly associated with polypharmacy. Cognitive impairment, disability, long-term pain syndrome and malignant diseases also predispose to polypharmacy. The absence of a permanent attending physician, living in a nursing home, consulting with several specialists, poor management of medical records are associated with polypharmacy. It is believed that polypharmacy leads to a following number of adverse consequences: it increases the risk of falls, side effects of M, hospitalizations and even death. The main reason for this is the occurrence of various adverse interactions between M, including unpredictable ones, but the causal relationship of these phenomena with polypharmacy is not always proven. To study of adherence to prescribed therapy with polypharmacy is not an easy task, to date, there is no clear answer to the question whether polypharmacy affects adherence to drug therapy. The article presents in detail the problems of potentially irrational prescriptions, discusses the main methods of preventing and combating polypharmacy. Obviously, the most acceptable methods are the cancellation of drugs that are not indicated or contraindicated to the patient, and the prescribing of those drugs for which there are direct indications, but which the patient does not receive. The patient’s therapy should be individualized as much as possible, taking into account numerous factors related to the peculiarities of the disease course, the prognosis, the patient’s lifestyle, his physical and mental status.
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来源期刊
Rational Pharmacotherapy in Cardiology
Rational Pharmacotherapy in Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.00
自引率
50.00%
发文量
79
审稿时长
6 weeks
期刊介绍: The primary goals of the Journal are consolidation of information on scientific and practical achievements in pharmacotherapy and prevention of cardiovascular diseases and continuing education of cardiologists and internists. The scientific concept of the edition suggests the publication of information on current achievements in cardiology, the results of national and international clinical trials. The Journal publishes original articles on the results of clinical trials designed to study the effectiveness and safety of drugs, analysis of clinical practice and its compliance with national and international recommendations, expert s’ opinions on a wide range of cardiology issues, associated conditions and clinical pharmacology. There is a heading “Preventive cardiology and public health” in the Journal to stimulate research interest in this highly demanded area. Memories of the outstanding people in medicine including cardiology, which are of great interest to historians of medicine, are published in "Our Mentors” heading.
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