社区老年慢病患者用药审查干预效果的系统评价

Systematic review of medication review intervention in community-dwelling elderly patients with chronic diseases

目的：了解国内外关于社区老年慢性病患者的用药审查干预的实施策略、运行进展、干预效果及出现的问题,为开展相关研究提供决策建议。方法：采用系统评价的方法对2005-2010年国内外公开发表的关于老年用药相关问题的用药审查干预的文献进行检索及评价。结果：共计8项研究纳入系统分析,累计干预人群863例,对照人群899例,涉及4个国家;干预的时间为8周~2年;干预的评价指标主要有从用药相关、患者相关、健康及生命质量相关这三个方面。结论：以药师为主导的用药审查对提高患者生命质量、降低住院率和死亡率无显著性影响,对精简用药数量,确定药学服务主题,提高患者药物治疗收益有较好的效果。

Objective To find out the implementation strategy ,operating progress ,intervention effects and problems of medication review of the implementation of intervention strategies, and to provide policy recommendations on related studies. MethodsRelated literatures published home and abroad were systematically reviewed. Results 8 items of study were included,involving 863 cases of intervention population, 899 cases of control population, from 4 different countries. Intervention time was between 8 weeks to 2 years. The main review indexes included the drug--related, patient -- related, health -- and -- quality -- of -- life -- related ones. Conclusion The pharmacist -- led medication review showed a positive influence of reducing potential drug- related problems （DRPs） in the elderly. But it did not significantly improve quality of life or ruduce hospitalization rates and deaths.