多病共患老年人群安全用药研究的文献计量学分析

Bibliometric analysis of studies on drug safety in the elderly with multiple diseases

目的探讨全球多病共患老年人群安全用药研究的现状、研究热点和发展趋势,为该领域研究提供理论参考。方法检索CNKI、中华医学期刊全文数据库和Web of Science数据库中多病共患老年人群安全用药研究的相关文献,时限为建库时间至2024年5月1日,采用R语言等软件对年度发文量、机构以及关键词的聚类、细化、热点趋势等方面进行文献可视化分析。结果共纳入中文文献20篇,英文文献654篇。全球对该领域的关注度不高,机构之间有待进一步加强合作。全科医学、全科医生、Beers标准、多重用药、初级保健、不适当用药、依从性、处方精简是全球该领域关注的重点方向。目前中文文献多从用药管理、干预措施等以临床实践角度开展研究;英文文献多从慢性疾病用药安全性、生命质量、药物依从性、慢性疾病用药风险等以患者角度开展研究。随着处方精简的研究热度上升,未来该领域用药管理研究将更加重视个性化和精准医疗。结论多病共患老年人群安全用药研究需建立健全初级保健机制,提高患者依从性,以及利用相关标准有效地对多病共患老年人群多重用药的安全性、潜在风险进行评估,识别潜在不适当用药,做到处方精简,从而降低药品不良反应发生的风险,进一步提高多病共患老年人群生活质量和降低医疗成本。

Objective To explore the current status,research hotspots and development trends of safe medication in the global elderly with multimorbidity,and to provide theoretical reference for research in this field.Methods CNKI,Yiigle and Web of Science were searched for studies on medication safety in the elderly with multimorbidity.The search time was from the establishment of the database to May 1,2024.R language and other software were used to visually analyze the annual number of publications,institutions,and the clustering,refinement,and hotspots and trends of keywords.Results A total of 20 Chinese articles and 654 English articles were included.There is little global attention to this field,and cooperation between institutions needs to be further strengthened.General practice,general practitioners,Beers criteria,polypharmacy,primary care,inappropriate prescribing,medication adherence,deprescribing are the key directions of concern in this field globally.At present,most of the Chinese literature is from the perspective of clinical practice,such as medication management and intervention measures.The English literature mainly focuses on the safety of chronic disease medication,quality of life,medication adherence,and risk of chronic disease medication from the patients'perspective.With the increasing popularity of deprescribing,future research in this area of medication management will place greater emphasis on personalized and precision medicine.Conclusions The study of drug safety in the elderly with multimorbidity needs to establish and improve the primary care mechanism,improve the adherence of patients,and use relevant standards to effectively evaluate the safety and potential risks of polypharmacy in the elderly with multimorbidity,identify potentially inappropriate drugs and deprescribing,to reduce the risk of adverse drug reactions,and to further improve the quality of life and reduce medical costs in the elderly with multimorbidity.