本文由小咖机器人翻译整理

期刊来源：BMJ

原文链接：https://doi.org/10.1136/bmj-2023-074892

摘要内容如下：

多药治疗在老年人中很常见，与药物不良事件、认知和功能障碍、医疗保健费用增加以及虚弱、跌倒、住院和死亡风险增加有关。取消处方存在许多障碍，但已加大努力制定和实施克服这些障碍的取消处方干预措施。这篇叙述性综述描述了干预措施的组成部分，并总结了已发表的随机对照试验的结果，这些试验测试了多用药的老年人的处方干预措施，以及关于正在进行的试验、指南和可用于促进处方干预的资源的报告。大多数干预措施是在初级保健机构中进行药物审查，许多干预措施包含共同决策和/或关注患者护理优先事项、对医疗保健专业人员的培训、面向患者的教育材料以及家庭成员的参与等内容，这表明针对老年人多药治疗的干预措施具有很大的异质性。研究发现，超过一半的研究干预措施在至少一项主要结果方面优于常规护理，并且大多数研究干预措施的评估时间为12个月或更短。

英文原文如下：

Abstracts

Polypharmacy is common in older adults and is associated with adverse drug events, cognitive and functional impairment, increased healthcare costs, and increased risk of frailty, falls, hospitalizations, and mortality. Many barriers exist to deprescribing, but increased efforts have been made to develop and implement deprescribing interventions that overcome them. This narrative review describes intervention components and summarizes findings from published randomized controlled trials that have tested deprescribing interventions in older adults with polypharmacy, as well as reports on ongoing trials, guidelines, and resources that can be used to facilitate deprescribing. Most interventions were medication reviews in primary care settings, and many contained components such as shared decision making and/or a focus on patient care priorities, training for healthcare professionals, patient facing education materials, and involvement of family members, representing great heterogeneity in interventions addressing polypharmacy in older adults. Just over half of study interventions were found to perform better than usual care in at least one of their primary outcomes, and most study interventions were assessed over 12 months or less.

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