Improving Medication Safety in Seniors: A Cross-Jurisdictional Linkage Project

该项目将确定解决目前澳大利亚65岁以上老年人因药物副作用而住院的流行病的优先事项。将对两组不同的药物进行调查。第一种将是最常被记录为住院原因的处方药，包括用于停止凝血、高血压和其他心血管问题的药物、用于风湿病或强烈止痛的药物、抗癌药物和类固醇。这项研究将检查在什么情况下服用这些药物的风险最高，以便更有针对性地进行预防。这项研究将调查是否对抗凝血药物进行了充分的实验室监测，以及是否应该更新指南。根据一个国际专家小组的说法，第二组将是68种老年人应该避免的药物。这项研究将了解在澳大利亚，这些“不适当的药物”在多长时间内仍被开出处方，以及它们对计划外住院时间的贡献有多大。研究人员怀疑，这个问题比常规统计数据显示的要大得多，因为不适当药物的许多副作用都是非特异性的，比如神志不清、昏昏欲睡或难以站立，从而使老年人面临跌倒和忽视健康其他方面的风险。这项研究将使用澳大利亚一种独特的新研究设施，该设施汇集了西澳各州和联邦各级全体人口的健康数据，包括药品、医疗保险使用、住院和死亡等信息。该设施的工作方式是保护患者和全科医生的隐私。这项研究的一个重要特点是，前往全科医生诊所就诊的具有代表性的自愿老年澳大利亚患者以及全科医生本身在向研究人员提供对消费者和全科医生重要的建议方面的参与程度。

The project will identify priorities for tackling the current epidemic of hospitalisation of Australians aged 65+ years due to side effects of their medications. Two different groups of medications will be investigated. The first will be the prescribed drugs most often recorded as causes of hospital stay, including those taken to stop blood clotting, for high blood pressure and other cardiovascular problems, for rheumatism or strong pain relief, anti-cancer drugs and steroids. The study will examine which of these drugs taken under what circumstances has the highest risk, so prevention can be better targeted. The study will investigate if adequate laboratory monitoring of the anti- clotting drugs is taking place and whether the guidelines should be updated. The second group will be 68 medications that should be avoided in seniors according to an international expert panel. The research will see how often these 'inappropriate medications' are still prescribed in the Australian setting, and the size of their contributions to unplanned hospital stays. The researchers suspect that this problem is much larger than immediately apparent from routine statistics, because many of the side effects of inappropriate medications are non-specific, such as confusion, drowsiness or difficulty standing up, thus putting seniors at risk of falls and neglect of other aspects of their health. The study will use a unique and new Australian research facility, which has brought together health data on the entire population of WA from both the State and Commonwealth levels, including information on pharmaceuticals, Medicare use, hospital stays and deaths. The facility works in such a way as to preserve patient and GP privacy. A strong feature of this research will be the degree of involvement of a representative and voluntary group of older Australian patients who attend GP clinics, and the GPs themselves, in advising the researchers on what's important to consumers and GPs.