摘要
目的探讨合理用药监测系统(PASS)对于降低老年患者药物不良事件(ADEs)发生率及提高临床医疗安全的作用。方法随机选取同济大学附属东方医院老年医学科及消化内科2007年7月至2009年7月老年患者(>65岁)为研究对象。第一阶段,两科均不使用PASS介入干预。第二阶段,老年医学科使用PASS介入干预;消化内科不介入干预。根据Naranjo评分表判定ADEs。比较两个科室前后阶段ADEs发生率、分布及严重程度,发生可预防ADEs患者的住院时间、住院费用的差异。结果 (1)老年医学科介入干预后,可预防ADEs及重度可预防ADEs发生率下降(P<0.01),消化内科前后阶段可预防ADEs及重度可预防ADEs发生率无显著差异。(2)两科室可预防ADEs中,重度事件所占比例多,干预治疗后,重度事件减少更显著。(3)老年医学科介入干预后,可预防ADEs相关的住院时间、住院费用都有所下降(P<0.01)。消化内科,前后阶段可预防ADEs相关的住院时间、住院费用无显著差异(P>0.05)。结论 ADEs在老年住院患者中普遍存在,越是严重的ADEs越可以防范。使用PASS对可预防性ADEs加强防范,有更多临床获益,可显著缩短住院时间,降低住院费用,减少医疗隐患,降低病残率,提高临床医疗安全。但其仍存在一定缺陷。
Objective To evaluate the effects of ＂Prescription Automatic Screening System （PASS）＂ on adverse drug events （ADEs） and improvement of clinical safety in elderly patients.Methods Elderly in-patients （65 years old） from Gerontology and Gastroenterology Departments,Dongfang Hospital Affiliated to Tongji Medical Universtiy from July 2007 to July 2009 were selected randomly.At phase Ⅰ,PASS was not used.At phase Ⅱ,PASS was used for patients from Gerontology Department,but not for patients from Gastroenterology Department.According to Naranjo score sheet,ADEs were determined.The incidence,distribution and severity of ADEs,and hospitalization duration and cost of preventable ADEs were compared between phase Ⅰ and phase Ⅱin the two departments.Results （1） The incidence of preventable ADEs and severe preventable ADEs decreased significanfly after PASS intervention （P0.01） in Gerontology Department,but there was no significant difference in Gastroenterology Department （P0.05）.（2） The severe events accounted for a maximum of ADEs,which decreased most significantly after PASS intervention.（3） Hospitalization duration and hospitalization costs for preventable ADEs decreased significantly （P0.01） in Gerontology Department after PASS intervention,but there was no significant difference （P0.05） in Gastroenterology Department.Conclusion ADEs are common in elderly in-patients.The more severe the ADEs is,the more possible is it be prevented.For preventable ADEs,PASS intervention can achieve more clinical benefit,including significantly shortening the hospitalization duration,lowering hospital costs,reducing medical risks,reducing morbidity,and improving clinical safety.However,there are still some shortcomings.
出处
《中华老年多器官疾病杂志》
2010年第2期114-117,122,共5页
Chinese Journal of Multiple Organ Diseases in the Elderly
基金
上海市科委重点科技支撑计划(08411951300)
关键词
老年人
药物不良事件
合理用药监测系统
elderly
adverse drug events
prescription automatic screening system
