老年高血压患者高风险用药目录的制定

Development of a List of High Risk Medications for the Chinese Elderly Hypertensive Patients

目的制定适合老年高血压患者的高风险用药目录,保证老年高血压患者用药安全。方法结合我国降压药品上市情况,采用循证方法查阅药品说明书、相关指南及中英文数据库中的相关文献,评价药物安全性,筛选出对老年高血压患者风险较高的药物并整理该类药物的风险点及用药建议,形成初始目录并制成第一轮调查问卷。专家论证过程采用德尔菲法征询专家意见,经过两轮函询根据专家反馈意见形成最终目录,即为老年高血压患者高风险用药目录。结果经过循证评价,共遴选出27个高风险药物、113个风险点及45条用药建议,形成初始目录;初始目录经两轮德尔菲法专家函询论证,最终遴选出氢氯噻嗪、硝苯地平、维拉帕米、哌唑嗪、利血平、可乐定6个高风险药物、12个风险点及12条用药建议制成最终目录。结论初步制定了适合我国老年高血压患者的高风险用药目录,促进老年高血压患者合理用药,降低用药风险。

OBJECTIVE To develop a list of high risk medications applicable to elderly hypertensive patients with an aim to ensure their medication safety. METHODS Refer to the antihypertensive drugs in China,we searched the drug instructions,guidelines and related literatures to access the medication safety. We singled out the medications with high risk for elderly hypertensive patients,and formulated a preliminary list. And then the Delphi method was adopted to seek professional advice,and formed the ultimate list.RESULTS Based on the accessment of literature,27 medications,113 risk points and 45 medication recommendations were selected out in order to form a preliminary list. After two rounds of circularizational argumentation by experts,6 medications（ namely Hydrochlorothiazide,Nifedipine,Verapamil,Prazosin,Reserpine,Clonidine）,12 risk points as well as 12 medication recommendations were picked to finalize the ultimate list. CONCLUSION The development of the list of high risk medication for Chinese elderly hypertensive patients has been completed preliminarily. The list will promote consciousness of rational drug-use,and improve drug safety in older adult.