Impact of Polypharmacy on the Rehabilitation Outcome of Japanese Stroke Patients in the Convalescent Rehabilitation Ward.
Impact of Polypharmacy on the Rehabilitation Outcome of Japanese Stroke Patients in the Convalescent Rehabilitation Ward.
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DOI：
10.1155/2016/7957825
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发表时间：
2016
影响因子：
4.7
通讯作者：
Hayashi H
中科院分区：
文献类型：
--
作者：
Kose E;Maruyama R;Okazoe S;Hayashi H
背景。与中风发作相关的危险因素是慢性肾脏疾病（CKD）。为了防止中风的再次发生，必须严格控制血压、血脂和血糖。因此，有些情况下被迫多药，尤其是老年患者。多种用药往往导致药物不良反应，并有可能对脑卒中患者的康复产生负面影响。本研究的目的是利用功能独立性测量（FIM）来研究多种药物的影响。方法。本分析共纳入144例卒中合并CKD患者。我们将卒中患者分为入院时服用6种及以上药物组（多药组）和服药少于6种药物组（非多药组）。比较患者背景特征、实验室数据和FIM评分。结果。FIM-Motor （FIM-M）效率、年龄和糖尿病与多药正相关。多药组FIM-M效率显著低于非多药组。结论。多种药物干扰卒中合并CKD患者的康复效果。药剂师和医生应该努力优化药物，以便能够对每个病人的结果作出反应。
Background. A risk factor associated with stroke onset is chronic kidney disease (CKD). To prevent stroke reoccurrence, it is necessary to strictly manage blood pressure, lipids, and plasma glucose. Therefore, some cases are forced to polypharmacy, elderly patients in particular. Polypharmacy often leads to adverse drug reactions and has the potential to negatively affect the rehabilitation of stroke patients. The aim of the present study was to investigate the effects of polypharmacy using a functional independence measure (FIM). Methods. A total of 144 stroke patients with CKD were included in the present analysis. We divided stroke patients into those taking six or more drugs (polypharmacy group) and those taking less than six drugs (nonpolypharmacy group) upon admission. Patient background features, laboratory data, and FIM scores were compared. Results. FIM-Motor (FIM-M) efficiency, age, and diabetes mellitus were positively associated with polypharmacy. FIM-M efficiency in the polypharmacy group was significantly lower than in the nonpolypharmacy group. Conclusion. Polypharmacy interferes with the effect of rehabilitation in stroke patients with CKD. Pharmacists and doctors should make efforts to optimize medications to be able to respond to the outcome of each patient.