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101.
Michael Dörks Katharina Allers Falk Hoffmann 《Journal of the American Medical Directors Association》2019,20(3):287-293.e7
Objectives
In addition to routinely administered long-term medication, complex drug regimens of nursing home residents often include as needed or pro re nata (PRN) medication. However, there has been no systematic evaluation of the frequency and concomitants of PRN medication in nursing homes. The main objective of this systematic review was to provide a current assessment of PRN drug use in nursing homes.Design
A systematic literature search was performed. Data were identified from 4 electronic bibliographic databases: MEDLINE, Embase, CINAHL, and Scopus. Studies were included if they reported quantitative data on PRN drug use in nursing home residents.Results
Our search strategy resulted in 484 hits, of which 27 articles satisfied the inclusion criteria. The mean number of PRN drugs ranged between 0.4 and 4.9 per resident with a median of 2.5. The proportion of residents prescribed at least 1 PRN drug was between 48.4% and 97.4% (median = 74.9). Administration of prescribed PRN medication was rather low as the proportion of residents with administered PRN drugs ranged from 28% to 55%. Frequently prescribed PRN drugs were analgesics, laxatives, and sedatives. Advanced age, dementia, a higher number of regularly scheduled medications, and length of stay in the nursing home were associated with higher use of PRN drugs.Conclusions/Implications
Although not regularly administered, PRN drug use in nursing home residents should be taken into account as part of complex drug regimens. In that sense, there seems to be an inadequate number of studies reporting on it. When screening tools like the Beers Criteria are adapted, PRN drugs should be included. 相似文献102.
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Aim: To investigate the prevalence of medication‐related problems (MRPs) in patients attending aged care and memory disorder clinics and explore the potential role of a clinical pharmacist to obtain medication histories and identify unresolved MRPs. Methods: The clinical pharmacist interviewed patients and reviewed their medication regimens in the outpatient clinics. Clinical significance of pharmacist‐identified MRPs was rated by an independent expert panel using validated criteria. Results: Forty‐six patients (mean age 82 years) were reviewed. They took a median of nine medications, of which three were not recorded in the medical record. One hundred and thirteen MRPs (median 2.0 per patient) were identified by the pharmacist. Independent review rated 35% of MRPs as high or extreme risk. Thirty‐seven (33%) MRPs related to medications not recorded in the medical record. Conclusions: Medication‐related problems were present for most patients. Involvement of a clinical pharmacist resulted in a more comprehensive medication history and identified unresolved MRPs. 相似文献
104.
Ken Fukunaga Yoshio Ohda Nobuyuki Hida Masaki Iimuro Yoko Yokoyama Koji Kamikozuru Kazuko Nagase Shiro Nakamura Hiroto Miwa Takayuki Matsumoto 《Journal of gastroenterology and hepatology》2012,27(12):1808-1815
Background and Aim: Topical mesalamine or corticosteroid has shown efficacy in patients with ulcerative proctitis, but patients often become refractory to these interventions. Xilei San is a herbal preparation with evidence of anti‐inflammatory effects. We evaluated the efficacy of topical Xilei San in ulcerative proctitis patients. Methods: In a double blind setting, 30 patients with intractable ulcerative proctitis despite ≥ 4 weeks of topical mesalamine or corticosteroid were randomly assigned to True (n = 15) and placebo (n = 15). Patients in True received suppository Xilei San (0.1 g/dose per day of Xilei San), the other 15 received placebo suppository. The initial efficacy was evaluated on day 14. Primary endpoint of the trial was avoiding relapse during 180 days, relapse meant recurrence of active disease. Riley's index was applied for endoscopic and histological evaluations, while patients' quality of life was evaluated by an inflammatory bowel disease questionnaire. Results: On day 14, the number of patients who achieved remission, clinical activity index ≤ 4 in True was significantly higher versus placebo (P < 0.04). Likewise, at day 180, an 81.8% of patients in True were without relapse versus 16.7% in placebo (P < 0.001). Further, significant endoscopic (P < 0.01), histological (P < 0.02) and inflammatory bowel disease questionnaire (P < 0.04) improvements were observed in True, but not in placebo. Conclusions: This is the first controlled investigation showing significant clinical and endoscopic efficacy for Xilei San in patients with intractable ulcerative proctitis. Topical Xilei San was well tolerated, and was without safety concerns. 相似文献
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目的将免疫抑制药物依从性Basel评估量表引入我国,并研究中文版免疫抑制药物依从性Basel评估量表在肝移植受者中应用的信效度。方法选取北京市某三级甲等医院移植随访门诊就诊的肝移植受者为研究对象。在征得量表研发方同意后,对量表进行跨文化调试。首先对量表进行翻译和回译,再根据专家委员会的意见对量表进行修改。并在正式调查前,对修改后的量表进行预调查。通过内在一致性信度以及2周重测信度对量表进行信度分析;通过探索性因子分析对其进行效度研究。结果量表的Cronbach'sα系数为0.697,重测信度为0.964;探索性因子分析提取了1个公因子,共解释54.73%的总方差变异。结论免疫抑制药物依从性Basel评估量表条目设置简明,在肝移植受者中应用信效度均较好。 相似文献