Beers标准评价老年人潜在不适当用药临床经济结局的系统评价

发布时间：2018-03-07 21:30

本文选题：Beers标准　切入点：老年人　出处：《中国临床药理学杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的系统评价2003或2012版Beers标准的应用对老年人临床、经济结局的影响,分析Beers标准的预测效力及可信度。方法计算机检索PubMed、Cochrane Library、中国知网(CNKI)、中国生物医学文献数据库(CBM)2003年至2016年公开发表的有关应用2003或2012版Beers标准识别老年人潜在不适当用药(PIM)并研究结局的文献。根据事先确定的入选与排除标准对检索到的文献进行筛选,用纽尔卡斯-渥太华(NOS)量表评价文献偏倚风险,最后提取数据进行Meta分析和描述统计。结果最终纳入了23篇文献,NOS量表评分均为6星以上。结果显示,经Beers标准判定存在潜在不适当用药的患者与不存在潜在不适当用药的患者相比,住院发生率高[OR=1.47,95%CI(1.14,1.89),P0.01];药物不良反应发生率高[OR=1.74,95%CI(1.23,2.47),P0.01];急诊发生率高[OR=1.69,95%CI(1.21,2.37),P0.01];医疗成本高,但是生活质量和死亡率差异无统计学意义(P0.05)。结论 Beers标准的应用能够降低住院、急诊和药物不良反应的发生率,降低患者的医疗成本。
[Abstract]:Objective to evaluate the clinical and economic outcomes of Beers in the elderly. Methods to analyze the predictive effectiveness and reliability of the Beers standard. Methods A computer-based search was conducted to identify potential discomfort in the elderly using the Beers standard published from 2003 to 2016, which was published from 2003 to 2016 in the PubMedus Cochrane Library, China Biomedical Literature Database. When PIMs were used and the outcome documents were studied, the retrieved documents were screened according to the pre-determined selection and exclusion criteria. The risk of bias of literature was evaluated with the Newkas-Ottawa scale, and the data were extracted for Meta analysis and descriptive statistics. The results included 23 articles with a score of more than 6 stars. The incidence of hospitalization was higher in patients with potentially inappropriate drug use than that in patients who did not have potentially inappropriate medication according to the Beers standard [OR1.47 / 95]; adverse drug reactions were high [OR1.74 / 95CII 1.232.47 / P0.01]; the incidence of emergency treatment was high [OR1.6995 / 95 CI 1.21 / 2.37 / P0.01], and the cost of medical treatment was high, and the rate of adverse drug reactions was higher than that of patients with potentially inappropriate use of drugs [OR1.67 / 95CII 1.21 / 2.37 / P0.01], and the incidence of adverse drug reactions was high [OR1.74 / 95 / 95 CIQ 1.21 / 2.37 / P0.01]. But there was no significant difference in quality of life and mortality (P 0.05). Conclusion the application of Beers standard can reduce the incidence of hospitalization, emergency and adverse drug reactions, and reduce the medical cost of patients.
【作者单位】：暨南大学药学院;广州军区广州总医院药剂科;
【基金】：广东省医学科学技术研究基金资助项目(B2016071) 广州市科技计划基金资助项目(201507020072);广州市科技计划基金资助项目(201509010012)
【分类号】：R96

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