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医护和患者对 MR 的认识方面都存在一定差距。在未 [ 8 ] 张莎,王婧,祝德秋. 社区老年慢病患者药物相关问题评
来开展我国社区老年患者 DRPs 的 MR 模式研究时,学 估及影响因素分析[J]. 中南药学,2020,18(6):1046-
者可考虑聚焦以下方面。(1)制定适宜我国国情的社区 1051.
老年患者 MR 模式相关政策:成立专项资金予以支持, [ 9 ] WUCHERER D,THYRIAN J R,EICHLER T,et al.
制定 MR 实施流程规范,明确社区药师在实施 MR 过程 Drug-related problems in community-dwelling primary
care patients screened positive for dementia[J]. Int Psycho‐
中的权利与义务。(2)推进MR模式建设:推进社区基层
geriatr,2017,29(11):1857-1868.
医疗机构中的多学科合作,促进社区全科医生、药师、护
[10] LENANDER C,BONDESSON Å,VIBERG N,et al. Ef‐
士及其他医疗保健人员组建多学科医疗服务团队,为社
fects of medication reviews on use of potentially inappro‐
区老年患者提供 MR 服务。(3)研制新的 DRPs 管理工
priate medications in elderly patients:a cross-sectional
具:尽管目前国内已有DRPs分类系统发布,但仍缺乏实 study in Swedish primary care[J]. BMC Health Serv Res,
践应用验证,需要进一步开展应用研究与改进,同时依 2018,18(1):616.
托信息化手段开发MR软件,以更有利于辅助药师进行 [11] ANG F Z,PAU J E,KOH E W,et al. Drug-related prob‐
临床决策,提高药师工作效率。(4)加强社区基层医疗卫 lems associated with community-dwelling older persons
生人员的培训和老年患者的宣教:上级医疗机构应定期 living alone in Singapore[J]. Int J Clin Pharm,2019,41
为基层医疗卫生人员组织培训,通过继续教育与考核来 (3):719-727.
提高基层医疗卫生人员的 DRPs 管理能力水平;应定期 [12] SILVA C,RAMALHO C,LUZ I,et al. Drug-related prob‐
就社区老年患者特点组织 DRPs 宣教,提高老年患者对 lems in institutionalized,polymedicated elderly patients:
DRPs 的认知度,增加该类人群对 MR 的接受度,从而提 opportunities for pharmacist intervention[J]. Int J Clin
Pharm,2015,37(2):327-334.
升合理用药管理水平。
[13] OHARA E,BANDO Y,YOSHIDA T,et al. Central ner‐
综上所述,MR是应对社区老年患者DRPs的有效手
vous system agent classes and fragility fracture risk
段,我国可借鉴英、美、澳等国的先进经验,积极探索构
among elderly Japanese individuals in a nationwide case-
建适宜我国国情的MR模式,以提高社区老年患者健康
crossover design study[J]. Biol Pharm Bull,2020,43(2):
水平、节约社会公共医疗资源。 340-347.
参考文献 [14] REALLON E,CHAVENT B,GERVAIS F,et al. Medica‐
[ 1 ] FANG E F,SCHEIBYE-KNUDSEN M,JAHN H J,et al. tion exposure and frailty in older community-dwelling pa‐
A research agenda for aging in China in the 21st century tients:a cross-sectional study[J]. Int J Clin Pharm,2020,
(2nd edition):focusing on basic and translational re‐ 42(2):508-514.
search,long-term care,policy and social networks[J]. [15] LEWIS J R,BARRE D,ZHU K,et al. Long-term proton
Ageing Res Rev,2020,64:101174. pump inhibitor therapy and Falls and fractures in elderly
[ 2 ] MIDÃO L,GIARDINI A,MENDITTO E,et al. Polyphar‐ women:a prospective cohort study[J]. J Bone Miner Res,
macy prevalence among older adults based on the survey 2014,29(11):2489-2497.
of health,ageing and retirement in Europe[J]. Arch Geron‐ [16] GOMM W,VON HOLT K,THOMÉ F,et al. Association
tol Geriatr,2018,78:213-220. of proton pump inhibitors with risk of dementia:a pharma‐
[ 3 ] KLOTZ U. Pharmacokinetics and drug metabolism in the coepidemiological claims data analysis[J]. JAMA Neurol,
elderly[J]. Drug Metab Rev,2009,41(2):67-76. 2016,73(4):410-416.
[ 4 ] Phrmaceutical Care Network Europe Association. Classifi‐ [17] PONTE MÁRQUEZ P H,TORRES O H,SAN-JOSÉ A,
cation for drug related problems[EB/OL].(2020-10-05) et al. Potentially inappropriate antihypertensive prescrip‐
[2022-07-05]. https://www.pcne.org/upload/files/417_PCNE_ tions to elderly patients:results of a prospective,observa‐
classification_V9-1_final.pdf. tional study[J]. Drugs Aging,2017,34(6):453-466.
[ 5 ] PLÁCIDO A I,HERDEIRO M T,MORGADO M,et al. [18] GRIESE-MAMMEN N,HERSBERGER K E,MESSERLI
Drug-related problems in home-dwelling older adults:a M,et al. PCNE definition of medication review:reaching
systematic review[J]. Clin Ther,2020,42(4):559-572. agreement[J]. Int J Clin Pharm,2018,40(5):1199-1208.
[ 6 ] YANG J D,MENG L,LIU Y,et al. Drug-related prob‐ [19] PSA. Guidelines for comprehensive medication manage‐
lems among community-dwelling older adults in mainland ment reviews[EB/OL]. [2022-10-17]. https://www. ppaon‐
China[J]. Int J Clin Pharm,2018,40(2):368-375. line.com.au/wp-content/uploads/2020/04/PSA-Guidelines-
[ 7 ] LAU E C Y,et al. Prevalence and risk factors for drug- for-Comprehensive-Medication-Management-Reviews.pdf.
related problems in people with dementia living in the [20] CMS. CY 2020 medication therapy management program
community:a systematic review and meta-analysis[J]. J guidance and submission instructions[EB/OL].(2020-09-
Am Med Dir Assoc,2022,23(6):980-991. 01)[2022-07-05].https://www.cms.gov/Medicare/Prescri-
中国药房 2023年第34卷第2期 China Pharmacy 2023 Vol. 34 No. 2 · 215 ·