出版社：Utrecht University, Maastricht University, Groningen University
摘要：Introduction: Drug therapy in older patients is becoming a worldwide concern due to the progressive increase in the number of drug prescriptions and the difficulties in ensuring appropriate prescribing. Appropriate prescribing in these patients is a complex problem that cannot be solved by simply applying clinical practice guidelines (CPG). Patients with multimorbidity usually show an evolution towards a progressive clinical, functional or cognitive impairment, which, in most cases, results in a limited life prognosis. In this scenario, drug therapy, which could have been appropriate in the past, can eventually become inappropriate as a disease progresses. Frail older patients are more sensitive to inappropriate prescribing (IP), as they suffer a reduction in their ability to tolerate medications due to changes in pharmacokinetics and pharmacodynamics. Consensus on the best procedure to optimize prescribing has not yet been established. In this context, we propose the use of a model which combines both the clinical judgment and the scientific evidence in a pragmatic and systematic approach. The main objective of this model is to identify potentially IP in a group of older patients and to optimize them according to care goals of each patient. Care goals are established through the application of the Patient-Centered Prescription Model, which is based on a shared decision-making process including patient, physicians and a clinical pharmacist. Description of practice : Each patient’s pharmacotherapeutic plan is assessed through application of the Patient-Centered Prescription Model[1,2]. In brief, this is a systematic three-step process carried out by a multidisciplinary team made up of geriatricians and a clinical pharmacist: Step 1 - Patient Centered Evaluation
关键词：patient-centered care ; inappropriate prescribing
