Epidemiology of medication-related adverse events in nursing homes.
Epidemiology of medication-related adverse events in nursing homes.
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DOI：
10.1016/j.amjopharm.2006.09.011
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发表时间：
2006-09-01
期刊：
影响因子：
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通讯作者：
Hanlon, Joseph T
中科院分区：
文献类型：
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作者：
Handler, Steven M;Wright, Rollin M;Hanlon, Joseph T
背景：疗养院居民开出的药物比任何其他临床环境下的患者都多。目的：本文回顾了近20年来有关养老院住院老人用药不良事件的描述性(发生率)和分析性(危险因素)流行病学研究。方法：应用计算机检索MEDLINE和国际药学文摘，检索1986-01/2006-07的相关文献，检索词为：不良药物事件、药物不良反应、药物停药、老年、药物治疗。与药物有关的问题、与药物有关的问题、疗养院、治疗失败和治疗失败。结果：有7篇文献符合纳入和排除标准，纳入本综述。5项研究描述了ADRs，1项研究描述了ADWE，1项研究描述了TFS。对ADRs的研究使用了不同的检测方法，导致每100个居民月的发病率从1.19到7.26不等。对ADWE的单一研究报告了每100个居民月的发病率为2.60。描述TFS的单一研究的发生率无法计算。结论：与药物相关的不良事件在疗养院环境中很常见。需要进行更多的研究，以加强对与药物有关的不良事件的检测和预防，并减少其对居民结局和医疗费用的影响。
BACKGROUND: Nursing home residents are prescribed more medications than patients in any other clinical setting. Although pharmacotherapy for older nursing home residents is usually safe and effective, it can lead to medication-related adverse events such as adverse drug reactions (ADRs), adverse drug withdrawal events (ADWEs), and therapeutic failures (TFs).OBJECTIVE: This article reviews the descriptive (incidence) and analytic (risk factor) epidemiology of medication-related adverse events occurring in nursing home residents as reported in the literature during the last 2 decades.METHODS: A search of MEDLINE and International Pharmaceutical Abstracts was conducted for articles published in English between January 1986 and July 2006 using the following terms: adverse drug events, adverse drug reactions, adverse drug withdrawal events, aged, drug therapy, drug-related problems, medication-related problems, nursing homes, therapeutic failures, and treatment failures. The reference lists of identified articles, recent review articles, book chapters, and the authors' reference library were also searched manually.RESULTS: Seven studies met the inclusion and exclusion criteria and were included in this review. Five studies described ADRs, 1 described ADWEs, and 1 described TFs. The studies of ADRs used different methods of detecting ADRs, resulting in incidence rates ranging from 1.19 to 7.26 per 100 resident-months. The single study of ADWEs reported an incidence of 2.60 per 100 resident-months. An incidence rate for the single study describing TFs could not be calculated.CONCLUSIONS: Medication-related adverse events are common in the nursing home setting. Additional studies are needed to enhance the detection and prevention of medication-related adverse events and to reduce their impact on residents' outcomes and health care costs.