处方精简在老年多重用药患者中的应用效果

Application Effect of Prescription Simplification for Elderly Patients with Multiple Medications

目的分析处方精简在老年多重用药患者中的应用效果。方法选取300例老年多重用药患者,均为本中心2021年1月—2022年12月所收治,按照药师有无进行评估精简将全部患者分为两组,对照组(n=190)仅接受常规用药咨询和处方审核服务,并没有开展处方精简,研究组(n=110)则在接受常规用药咨询及处方审核服务的基础上,开展处方精简,对两组的使用药品种类数、药品费用、死亡情况进行观察分析。结果全部110例研究组患者进行处方精简后,并没有出现撤药后不良反应;其中精简1种药物的患者共有107例,占比为97.27%(107/110),精简2种药物的患者共有3例,占比为2.73%(3/110)。根据药理作用对精简药物进行分类,精简药物主要为代谢及内分泌用药、神经系统用药、心血管系统用药等;精简方式主要为停药、减量,其中共有75例患者为减量,占比为68.18%(75/110);全部110例患者中,主要的药物治疗问题为给药剂量过高、不必要药物治疗、药物不良反应以及患者不依从。与对照组相比,研究组的治疗总费用明显减少(P<0.05);而在药品种类数、药品费用方面,两组比较差异无统计学意义(P>0.05)。随访观察期间,两组均无患者发生死亡。结论在老年多重用药患者中应用处方精简能对药物治疗方案进行优化,让不必要的治疗药物明显减少,进而让治疗费用明显减少,值得推广。

Objective To analyze application effect of prescription simplification for elderly patients with multiple drug use.Methods The paper chose 300 elderly patients with multiple drug use admitted to our community center from January 2021 to December 2022,and divided them into two groups based on evaluation and simplification conducted by pharmacists.Control group(n=190)was treated with routine drug consultation and prescription review services only,and no prescription simplification.Study group(n=110)was treated with prescription simplification on the basis of routine drug consultation and prescription review services.Number of types of drugs use,drug costs,and mortality rates were observed and analyzed between two groups.Results After prescription simplification,110 patients in study group experienced no adverse reactions after withdrawal,107 patients simplified with one drug,accounting for 97.27%(107/110),and 3 patients simplified two drugs,accounting for 2.73%(3/110).the paper classified simplified drugs based on pharmacological effect,mainly including metabolic and endocrine drugs,nervous system drugs,cardiovascular system drugs,etc.Main simplification methods included discontinuation and reduction of medication,with 75 patients with reduction,accounting for 68.18%(75/110).Among 110 patients,main drug treatment issues were excessive dosage,unnecessary drug treatment,adverse drug reactions,and patient noncompliance.Total treatment cost of study group was significantly less than control group(P<0.05).However,there was no statistically significant difference in number of drug types and drug costs between two groups(P>0.05).During follow-up observation period,there were no deaths in either group.Conclusion Prescription simplification can optimize drug treatment plans,significantly reduce unnecessary treatment drugs,and reduce treatment costs of elderly patients with multiple drug use significantly,which is worth promoting.