药物不良反应杂志
藥物不良反應雜誌
약물불량반응잡지
ADVERSE DRUG REACTIONS JOURNAL
2014年
2期
74-78
,共5页
闫妍%王育琴%沈芊%刘琛%唐静
閆妍%王育琴%瀋芊%劉琛%唐靜
염연%왕육금%침천%류침%당정
老年人%方案评价%潜在不适当用药%Beers标准
老年人%方案評價%潛在不適噹用藥%Beers標準
노년인%방안평개%잠재불괄당용약%Beers표준
Aged%Program evaluation%Potentially inappropriate medications%Beers criteria
目的 对美国等8个国家老年人潜在不适当用药(PIM)判断标准进行比较,为制定我国老年人PIM判断标准提供参考. 方法 采用数据库和网络检索方法收集国外已经发布的老年人PIM判断标准,检索时间截至2012年12月.从中选取8个国家的老年人PIM判断标准,主要就标准的制定方法、专家组构成、标准内容等情况进行比较. 结果 纳入分析的为美国、加拿大、日本、法国、挪威、德国、韩国和奥地利等8个国家的老年人PIM判断标准.除美国判断标准已更新至第4版(2012年)外,其余国家均为首次制定.各国标准的适用人群年龄略有差别(≥65～≥75岁).除日本外的其他国家均采用德尔菲法作为研究方法.专家组人员构成有药学人员和老年医学专家、精神科专家、全科/家庭医生等.8个国家的标准在内容和形式上不完全一致,内容主要为3个方面:(1)独立的药物风险;(2)疾病-药物相互作用所致的风险;(3)药物相互作用所致的风险.被标准纳入的药物具有以下特点:(1)老年人使用后易产生毒性和不良反应;(2)老年人使用后风险大于获益;(3)老年人使用后疗效不佳或疗效不确定;(4)可被较安全的同类药物替代. 结论 参考和借鉴国外制定老年人PIM判断标准的方法和经验,有助于早日制定出符合我国国情的老年人PIM判断标准,促进老年人合理用药.
目的 對美國等8箇國傢老年人潛在不適噹用藥(PIM)判斷標準進行比較,為製定我國老年人PIM判斷標準提供參攷. 方法 採用數據庫和網絡檢索方法收集國外已經髮佈的老年人PIM判斷標準,檢索時間截至2012年12月.從中選取8箇國傢的老年人PIM判斷標準,主要就標準的製定方法、專傢組構成、標準內容等情況進行比較. 結果 納入分析的為美國、加拿大、日本、法國、挪威、德國、韓國和奧地利等8箇國傢的老年人PIM判斷標準.除美國判斷標準已更新至第4版(2012年)外,其餘國傢均為首次製定.各國標準的適用人群年齡略有差彆(≥65～≥75歲).除日本外的其他國傢均採用德爾菲法作為研究方法.專傢組人員構成有藥學人員和老年醫學專傢、精神科專傢、全科/傢庭醫生等.8箇國傢的標準在內容和形式上不完全一緻,內容主要為3箇方麵:(1)獨立的藥物風險;(2)疾病-藥物相互作用所緻的風險;(3)藥物相互作用所緻的風險.被標準納入的藥物具有以下特點:(1)老年人使用後易產生毒性和不良反應;(2)老年人使用後風險大于穫益;(3)老年人使用後療效不佳或療效不確定;(4)可被較安全的同類藥物替代. 結論 參攷和藉鑒國外製定老年人PIM判斷標準的方法和經驗,有助于早日製定齣符閤我國國情的老年人PIM判斷標準,促進老年人閤理用藥.
목적 대미국등8개국가노년인잠재불괄당용약(PIM)판단표준진행비교,위제정아국노년인PIM판단표준제공삼고. 방법 채용수거고화망락검색방법수집국외이경발포적노년인PIM판단표준,검색시간절지2012년12월.종중선취8개국가적노년인PIM판단표준,주요취표준적제정방법、전가조구성、표준내용등정황진행비교. 결과 납입분석적위미국、가나대、일본、법국、나위、덕국、한국화오지리등8개국가적노년인PIM판단표준.제미국판단표준이경신지제4판(2012년)외,기여국가균위수차제정.각국표준적괄용인군년령략유차별(≥65～≥75세).제일본외적기타국가균채용덕이비법작위연구방법.전가조인원구성유약학인원화노년의학전가、정신과전가、전과/가정의생등.8개국가적표준재내용화형식상불완전일치,내용주요위3개방면:(1)독립적약물풍험;(2)질병-약물상호작용소치적풍험;(3)약물상호작용소치적풍험.피표준납입적약물구유이하특점:(1)노년인사용후역산생독성화불량반응;(2)노년인사용후풍험대우획익;(3)노년인사용후료효불가혹료효불학정;(4)가피교안전적동류약물체대. 결론 삼고화차감국외제정노년인PIM판단표준적방법화경험,유조우조일제정출부합아국국정적노년인PIM판단표준,촉진노년인합리용약.
Objective Compare criteria of eight countries such as United States for potentially inappropriate medications (PIM) in elderly,to provide a reference for formulating China's PIM criteria.Methods Using the database and network,the authors collect the PIM criteria in elderly that has been released from the inception to December 2012.Eight countries PIM criteria were selected and their development method,expert panel's composition and contents were compared.Results PIM criteria from a total of eight countries including the United States,Canada,Japan,France,Norway,Germany,South Korea and Austria were selected for the analysis.Except the United States PIM criteria has been updated to version 4 (2012),the other countries have just published their first edition.The applicable age of respective country about PIM criteria is slightly different (≥ 65 ～ ≥ 75 years).Seven countries except Japan were using the Delphi method as a research methodology.The composition of the expert panel has pharmacist,geriatrician,psychiatrist,general and family practitioner,and so on.Eight countries' PIM criteria were not completely consistent in the content and the form,but mainly contain three parts:independent risk factors,drug-disease interactions,and drug-drug interactions.Drugs were included in PIM criteria with the following features:the elderly are prone to poisoning and adverse reactions; the benefits of treatment outweigh its potential risks for the elderly; poor efficacy or uncertain efficacy for the elderly; drugs can be replaced with similar products.Conclusion Reference and learning from foreign method and experience of PIM criteria in elderly can help us to formulate a PIM criteria for China's situation as early as possible and promote rational use of drugs.
