中国全科医学 ›› 2025, Vol. 28 ›› Issue (36): 4550-4557.DOI: 10.12114/j.issn.1007-9572.2025.0046

• 指南解读 • 上一篇    下一篇

意大利科学联盟立场声明解读:药物审查和处方精简

孙佳颖1, 周鹏翔2, 夏瑀3, 严明4, 周馨媚5, 吴玲燕5, 童钰铃5, 赵洋6,7,*(), 徐志杰5,*()   

  1. 1.315324 浙江省宁波市,宁波前湾新区社区卫生服务中心
    2.100191 北京市,北京大学第三医院药学部
    3.518036 广东省深圳市,北京大学深圳医院全科医学科
    4.310016 浙江省杭州市,浙江大学医学院附属邵逸夫医院全科医学科
    5.310009 浙江省杭州市,浙江大学医学院附属第二医院全科医学科
    6.2050 澳大利亚悉尼,新南威尔士大学乔治全球健康研究院
    7.3010 澳大利亚墨尔本,墨尔本大学人口与全球健康学院
  • 收稿日期:2025-01-10 修回日期:2025-04-15 出版日期:2025-12-20 发布日期:2025-12-04
  • 通讯作者: 赵洋, 徐志杰

  • 作者贡献:

    孙佳颖、徐志杰负责文章的构思与设计、可行性分析、论文撰写;夏瑀、周馨媚负责文献资料收集和整理;周鹏翔、严明、吴玲燕对文章提出了修改建议;童钰玲、赵洋、徐志杰负责质量控制及审校,并对文章负责。

  • 基金资助:
    国家自然科学基金资助项目(72304008); 浙江省医药卫生科技计划(2023KY748,2024KY1026); 国家重点研发计划(2022YFF0902004)

Interpretation of a Position Statement from an Italian Scientific Consortium: Medication Review and Deprescribing

SUN Jiaying1, ZHOU Pengxiang2, XIA Yu3, YAN Ming4, ZHOU Xinmei5, WU Lingyan5, TONG Yuling5, ZHAO Yang6,7,*(), XU Zhijie5,*()   

  1. 1. Qianwan New District Community Health Service Center of Ningbo, Ningbo 315324, China
    2. Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
    3. Department of General Practice, Peking University Shenzhen Hospital, Shenzhen 518036, China
    4. Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
    5. Department of General Practice, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
    6. The George Institute for Global Health, University of New South Wales, Sydney 2050, Australia
    7. School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
  • Received:2025-01-10 Revised:2025-04-15 Published:2025-12-20 Online:2025-12-04
  • Contact: ZHAO Yang, XU Zhijie

摘要: 多病共存易导致多种药物联用,增加了药物相互作用和药物不良反应的风险。药物审查和处方精简是优化药物治疗方案的重要策略,目标在于通过审查和减少不适当用药,改善患者的整体健康水平和生活质量。2024年3月,意大利科学联盟发布了关于药物审查和处方精简的立场声明,陈述了药物审查和处方精简的关键要素、方法、可用工具与应用价值。本文基于分析该声明的主要内容,介绍药物审查和处方精简的概念和目标,从全面回顾用药史、药物治疗评估、多学科药物治疗计划和随访4个方面阐述其主要过程,总结综述其在不同医疗环境中的实施效果,分析我国面临的挑战及应对策略,旨在为促进临床医生为患者开展药物审查和处方精简提供理论依据。

关键词: 药物处方, 药物审查, 处方精简, 多重用药, 不适当用药, 立场声明, 解读

Abstract:

Multimorbidity often leads to polypharmacy, increasing the risk of drug interactions and adverse drug reactions. Medication review and deprescribing are crucial strategies for improving therapeutic regimens, aiming to enhance patients' overall health and quality of life through reviewing and reducing inappropriate medication use. In March 2024, the Italian Scientific Consortium issued a position statement on medication review and deprescribing, outlining their key elements, methods, available tools, and clinical value. Based on an analysis of this statement, this article introduces the concepts and objectives of medication review and deprescribing. It elaborates on the main processes from four aspects: comprehensive medication history review, medication therapy assessment, multidisciplinary medication therapy planning, and follow-up. The article reviews implementation outcomes across different healthcare settings, analyzes challenges and coping strategies in China, and aims to provide theoretical support for promoting medication review and deprescribing by clinicians for their patients.

Key words: Drug prescriptions, Medication review, Deprescribing, Polypharmacy, Inappropriate medications, Position statement, Interpretation

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