老年患者多重用药管理的最佳证据总结

doi:10.3761/j.issn.1672-9234.2023.02.016

摘要/Abstract

摘要： 目的总结老年多重用药患者用药管理的最佳证据，为规范老年患者多重用药管理提供循证依据。方法检索BMJ Best Practice、UpToDate、美国国立临床诊疗指南数据库、英国国家卫生与临床优化研究所、加拿大安大略注册护士协会、医脉通、澳大利亚乔安娜布里格斯研究所（Joanna Briggs Institute，JBI）循证卫生保健中心数据库、Cochrane Library、PubMed、中国知网、万方等数据库及网站中有关老年多重用药患者用药管理的相关证据，检索时限为建库至2022年2月。采用JBI循证卫生保健中心的文献质量评价标准和证据分级系统对纳入文献进行质量评价和分级汇总。结果共纳入8篇文献，其中指南2篇，专家共识4篇，系统评价2篇。共总结出老年多重用药患者用药安全评估、管理支持、教育、自我管理4个方面的19条证据。结论本研究证据总结过程较为具体、全面、科学，临床医护人员需结合医院实际、临床情景、患者个体情况选择最佳证据应用于临床，从而规范患者用药管理行为，保证用药安全。

关键词: 老年人, 循证护理学, 多重用药, 用药管理, 证据总结

Abstract:

Objective To summarize the best evidence of medication management in elderly patients with polypharmacy and provide reference for management of multi-drug administration for elderly patients. Methods Relevant evidence on medication management in elderly patients with polypharmacy was retrieved，including BMJ Best Practice，UpToDate，National Guideline Clearinghouse，National Institute for Health and Care Excellence，Registered Nurses Association of Ontario，Medive，Joanna Briggs Institute Library，Cochrane Library，PubMed，CNKI，Wanfang，etc.. The time limit was set from the establishment of the database to February，2022. The quality assessment and classification were conducted by researchers using the quality evaluation standard and evidence grading system of JBI evidence-based health care center. Results A total of eight references were enrolled，including two guidelines，four expert consensus reports，two systematic reviews. Nineteen pieces of evidence were obtained，including safety assessment，management support，education and self-management.Conclusion The process of evidence production is specific，comprehensive and scientific. Clinical healthcare professionals should select the best evidence for clinical application in combination with actual situation of the hospital，clinical context and individual condition of patients to standardize the practice of patients’ medication management and ensure medication safety.

Key words: Aged, Evidence-Based Nursing, Polypharmacy, Medication therapy management, Evidence summary

程婷, 涂惠, 郭婷, 李欣, 徐文君, 彭莹, 张娜. 老年患者多重用药管理的最佳证据总结[J]. 中华护理教育, 2023, 20(2): 217-222.

CHENG Ting, TU Hui, GUO Ting, LI Xin, XU Wenjun, PENG Ying, ZHANG Na. Summary of the best evidence for medication management in elderly patients with polypharmacy[J]. Chinese Journal of Nursing Education, 2023, 20(2): 217-222.

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