开发药物状态检查表,识别对药物理解不清的患者:日本多中心研究

Tomoya Obara , Ryota Kumaki , Hiroshi Shinonaga , Yasushi Takai , Keiichiro Higashi , Maho Tatsumi , Hiroko Otsubo , Makoto Akao , Koji Muto , Akie Yamaguchi , Yoshitomo Shimazaki , Keiko Kishimoto
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引用次数: 0

摘要

背景 造成多种药物滥用的原因之一是由于对药物缺乏了解而漫无目的地用药。然而,有些患者并不充分了解药物的适应症和多种药物的不良反应。本研究旨在开发一种筛查工具--药物状态检查(MSC),以识别对药物理解不充分的患者,从而减少日本的无目的用药。在 2023 年 9 月至 2024 年 3 月期间,对年龄≥75 岁的住院患者进行了调查。通过卡方检验确定了 19 个 MSC 草案项目与药物理解差和药物理解好之间的关系。结果总体而言,由 2 个 MSC 草案问题和使用≥5 种药物组成的 3 个项目被指定为 MSC-3。ROC 曲线下的面积为 0.686(95 % 置信区间:0.582-0.778,P < 0.001),表明 MSC-3 作为筛查工具是有用的。结论 使用 MSC-3 可以让药剂师在早期阶段进行干预,从而降低多药滥用的发生率。
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Development of a medication status check sheet to identify patients with poor understanding of their medications: A multicenter study in Japan

Background

One of the causes of polypharmacy is aimless medication use due to poor understanding of medications. However, some patients do not adequately understand the indication for medications and adverse effects of polypharmacy. This study aimed to develop a screening tool, the medication status check (MSC), to identify patients with poor understanding of their medications to reduce aimless medication use in Japan.

Methods

This multicenter, prospective, observational study was conducted in nine hospitals in Japan. Inpatients aged ≥75 years were surveyed between September 2023 and March 2024. A chi-squared test was conducted to determine the relationship of the 19 MSC draft items with poor and good understanding of medications. A receiver operating characteristic (ROC) analysis was then performed using significant questions (i.e., those with a P-value of <0.05), and cut-off values were obtained.

Results

Overall, 3 items, comprising 2 of the draft MSC questions and the use of ≥5 medications, were designated as the MSC-3. The area under the ROC curve was 0.686 (95 % confidence interval: 0.582–0.778, P < 0.001), indicating that the MSC-3 was useful as a screening tool. When at least one of the MSC-3 items was met, this approach resulted in a sensitivity of 93.1 % and specificity of 21.7 % in identifying the need for polypharmacy intervention.

Conclusions

Use of the MSC-3 will enable pharmacists to intervene at an early stage, potentially contributing to a reduction in the incidence of polypharmacy.
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