Polypharmacy in elderly patients.
Polypharmacy in elderly patients.
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DOI：
10.1016/j.amjopharm.2007.12.002
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发表时间：
2007-12-01
期刊：
影响因子：
--
通讯作者：
Hanlon, Joseph T
中科院分区：
文献类型：
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作者：
Hajjar, Emily R;Cafiero, Angela C;Hanlon, Joseph T
背景技术背景：多重用药（即使用多种药物和/或给予比临床指示更多的药物，代表不必要的药物使用）在老年人中很常见。目的：本研究的目的是提供一个观察性研究的描述，检查多种药物的流行病学，并审查随机对照研究，已发表在过去20年中，旨在减少多种药物在老年人adults.METHODS:本综述的材料来自MEDLINE数据库（1986- 2007年6月）和国际药学文摘（1986- 2007年6月）的检索，以识别年龄>65岁的文章。我们使用了以下检索词的组合：多药、多种药物、多药、老年人、老年人和老年人。从已识别的文章和作者的文章文件、书籍章节和最近的综述中手动检索参考文献列表，以识别其他文章。从这些，作者确定了这些研究，测量multipharmacy.RESULTS：文献综述发现，多药治疗继续增加，是一个已知的危险因素，重要的发病率和死亡率。很少有严格设计的干预研究被证明可以减少老年人不必要的多种药物治疗。文献综述识别出5篇文章，此处纳入。所有的研究表明，在polypharmacy.CONCLUSIONS：许多研究发现，各种数量的药物与负面的健康结果，但需要更多的研究，以进一步描绘与不必要的药物使用在老年患者的后果。医疗保健专业人员应了解风险，并在每次患者访视时充分评估所有药物，以防止发生多药治疗。
BACKGROUND: Polypharmacy (ie, the use of multiple medications and/or the administration of more medications than are clinically indicated, representing unnecessary drug use) is common among the elderly.OBJECTIVE: The goal of this research was to provide a description of observational studies examining the epidemiology of polypharmacy and to review randomized controlled studies that have been published in the past 2 decades designed to reduce polypharmacy in older adults.METHODS: Materials for this review were gathered from a search of the MEDLINE database (1986-June 2007) and International Pharmaceutical Abstracts (1986-June 2007) to identify articles in people aged >65 years. We used a combination of the following search terms: polypharmacy, multiple medications, polymedicine, elderly, geriatric, and aged. A manual search of the reference lists from identified articles and the authors' article files, book chapters, and recent reviews was conducted to identify additional articles. From these, the authors identified those studies that measured polypharmacy.RESULTS: The literature review found that polypharmacy continues to increase and is a known risk factor for important morbidity and mortality. There are few rigorously designed intervention studies that have been shown to reduce unnecessary polypharmacy in older adults. The literature review identified 5 articles, which are included here. All studies showed an improvement in polypharmacy.CONCLUSIONS: Many studies have found that various numbers of medications are associated with negative health outcomes, but more research is needed to further delineate the consequences associated with unnecessary drug use in elderly patients. Health care professionals should be aware of the risks and fully evaluate all medications at each patient visit to prevent polypharmacy from occurring.