Adverse Reactions/Medication Safety: Beyond the Beers Criteria: A Comparative Overview of Explicit Criteria
Adverse Reactions/Medication Safety: Beyond the Beers Criteria: A Comparative Overview of Explicit Criteria
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不良反应/药物安全：超越啤酒标准：明确标准的比较概述
DOI：
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发表时间：
2010
期刊：
影响因子：
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通讯作者：
Catherine Christen
中科院分区：
文献类型：
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作者：
H. B. Levy;E. Marcus;Catherine Christen
目的：提供自2003年以来针对老年人不适当处方制定的明确标准的比较概述，并将这些新标准与2003年发布的最新Beers标准进行对比。数据来源：MEDLINE和Google Scholar检索时间为2003年至2010年7月。在MEDLINE中。MeSH术语包括年龄、药物处方、用药错误和多药治疗。自由文本检索词包括老年人、指南依从性、不适当处方和药物。也使用了MEDLINE识别的相关文章。在Google Scholar上进行自由文本检索，使用“潜在不适当处方老年人”。在关键文章参考文献列表、研究选择和数据提取中确定了其他文章：如果研究是在2003年Beers标准最近一次修订后发表的，并且涉及老年人明确标准的制定和应用，则选择研究。我们独立审查了相关文献，以提取关键信息。数据合成：第一个明确的标准是Beers标准，大多数关于不适当药物使用的研究都采用了这些标准。继Beers标准之后制定的标准包括法国共识小组清单、STOPP（老年人处方筛选工具）和START（提醒医生正确治疗的筛选工具）、澳大利亚处方指标工具和挪威全科医学标准。较新的标准对Beers标准进行了几项改进，即药物相互作用，省略潜在的有益治疗，以及更广泛地适用于国际边界的标准。结论：虽然没有标准可能是全球适用的，STOPP和START取得了重大进展。区域药物可用性、经济因素和临床实践模式影响标准选择。在不同的实践环境中验证几个较新的标准，并探讨遵守指南对患者结局的影响是必要的。这些研究的数据将有助于从业人员确定首选标准。
Objective: To provide a comparative overview of explicit criteria that have been developed since 2003 for inappropriate prescribing in older adults and to contrast these newer criteria with the most recent Beers criteria, published in 2003. Data Sources: MEDLINE and Google Scholar searches were performed from 2003 through July 2010. Within MEDLINE. MeSH terms included aged, drug prescriptions, medication errors, and polypharmacy. Free-text search terms included elderly, guideline adherence, inappropriate prescribing, and medications. Related articles, as identified by MEDLINE, were used as well. Free-text search was performed on Google Scholar, using “potentially inappropriate prescribing elderly.” Additional articles were identified in reference lists of key articles, Study Selection and Data Extraction: Studies were selected if they were published after the most recent revision of the Beers criteria in 2003 and addressed the development and application of explicit criteria for the elderly. We independently reviewed pertinent literature to extract key information. Data Synthesis: The first explicit criteria published were the Beers criteria, and most research regarding inappropriate medication use applied these criteria. Criteria developed subsequent to the Beers criteria include the French Consensus Panel list, STOPP (Screening Tool of Older Persons' Prescription) and START (Screening Tool to Alert doctors to Right Treatment), the Australian Prescribing Indicators tool, and the Norwegian General Practice Criteria. Newer criteria offer several improvements on the Beers criteria, namely drug-drug interactions, omission of potentially beneficial therapy, and more broadly applicable criteria across international borders. Conclusions: Although no criteria may ever be globally applicable, STOPP and START make significant advances. Regional drug availability, economic considerations, and clinical practice patterns impact criteria selection. Research to validate the several newer criteria in various practice settings and to explore the effect of adhering to the guidelines on patient outcomes is warranted. Data from such research will aid practitioners in identifying preferred criteria.