Managing Medications in Clinically Complex Elders "There's Got to Be a Happy Medium"

被引:231
作者
Steinman, Michael A. [1 ,2 ]
Hanlon, Joseph T. [3 ,4 ,5 ,6 ]
机构
[1] San Francisco VA Med Ctr, San Francisco, CA 94121 USA
[2] Univ Calif San Francisco, Div Geriatr, San Francisco, CA 94143 USA
[3] Univ Pittsburgh, Dept Epidemiol, Dept Med, Div Geriatr Med, Pittsburgh, PA 15261 USA
[4] Univ Pittsburgh, Dept Pharm & Therapeut, Pittsburgh, PA USA
[5] Vet Affairs Pittsburgh Healthcare Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA USA
[6] Vet Affairs Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 2010年 / 304卷 / 14期
基金
美国医疗保健研究与质量局;
关键词
ADVERSE DRUG EVENTS; EMERGENCY-DEPARTMENT VISITS; OLDER-ADULTS; RISK-FACTORS; DISCONTINUING MEDICATIONS; PHARMACIST INTERVENTION; GENERAL-PRACTITIONERS; QUALITY INDICATORS; ADVANCED DEMENTIA; CONTROLLED-TRIAL;
D O I
10.1001/jama.2010.1482
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Multiple medication use is common in older adults and may ameliorate symptoms, improve and extend quality of life, and occasionally cure disease. Unfortunately, multiple medication use is also a major risk factor for prescribing and adherence problems, adverse drug events, and other adverse health outcomes. Using the case of an older patient taking multiple medications, this article summarizes the evidence-based literature about improving medication use and withdrawing specific drugs and drug classes. It also describes a systematic approach for how health professionals can assess and improve medication regimens to benefit patients and their caregivers and families. JAMA. 2010;304(14):1592-1601 www.jama.com
引用
收藏
页码:1592 / 1601
页数:10
相关论文
共 97 条
[1]   The relationship between number of medications and weight loss or impaired balance in older adults [J].
Agostini, JV ;
Han, L ;
Tinetti, ME .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2004, 52 (10) :1719-1723
[2]   Discontinuing medications: A novel approach for revising the prescribing stage of the medication-use process [J].
Bain, Kevin T. ;
Holmes, Holly M. ;
Beers, Mark H. ;
Maio, Vittorio ;
Handler, Steven M. ;
Pauker, Stephen G. .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2008, 56 (10) :1946-1952
[3]   Interventions to Improve Medication Reconciliation in Primary Care [J].
Bayoumi, Imaan ;
Howard, Michelle ;
Holbrook, Anne M. ;
Schabort, Inge .
ANNALS OF PHARMACOTHERAPY, 2009, 43 (10) :1667-1675
[4]   Discrepancies in the use of medications -: Their extent and predictors in an out-patient practice [J].
Bedell, SE ;
Jabbour, S ;
Goldberg, R ;
Glaser, H ;
Gobble, S ;
Young-Xu, Y ;
Graboys, TB ;
Ravid, S .
ARCHIVES OF INTERNAL MEDICINE, 2000, 160 (14) :2129-2134
[5]   Effect of vitamin D on falls - A meta-analysis [J].
Bischoff-Ferrari, HA ;
Dawson-Hughes, B ;
Willett, WC ;
Staehelin, HB ;
Bazemore, MG ;
Zee, RY ;
Wong, JB .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 291 (16) :1999-2006
[6]   Prevention of Nonvertebral Fractures With Oral Vitamin D and Dose Dependency A Meta-analysis of Randomized Controlled Trials [J].
Bischoff-Ferrari, Heike A. ;
Willett, Walter C. ;
Wong, John B. ;
Stuck, Andreas E. ;
Staehelin, Hannes B. ;
Orav, John ;
Thoma, Anna ;
Kiel, Douglas P. ;
Henschkowski, Jana .
ARCHIVES OF INTERNAL MEDICINE, 2009, 169 (06) :551-561
[7]   Prescribing discrepancies likely to cause adverse drug events after patient transfer [J].
Boockvar, K. S. ;
Liu, S. ;
Goldstein, N. ;
Nebeker, J. ;
Siu, A. ;
Fried, T. .
QUALITY & SAFETY IN HEALTH CARE, 2009, 18 (01) :32-36
[8]  
*BOST U SLON EP CT, 2006, PATT MED US US
[9]   Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases - Implications for pay for performance [J].
Boyd, CM ;
Darer, J ;
Boult, C ;
Fried, LP ;
Boult, L ;
Wu, AW .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 294 (06) :716-724
[10]   National surveillance of emergency department visits for outpatient adverse drug events [J].
Budnitz, Daniel S. ;
Pollock, Daniel A. ;
Weidenbach, Kelly N. ;
Mendelsohn, Aaron B. ;
Schroeder, Thomas J. ;
Annest, Joseph L. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2006, 296 (15) :1858-1866