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Randomized controlled intervention in cardiovascular drug treatment in nursing homes.

机译：疗养院心血管药物治疗的随机对照干预。

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OBJECTIVE: To study drug treatment of patients with cardiovascular diseases (heart failure, post-myocardial infarction, angina pectoris, hypertonia or cardiac valvular disease) in nursing homes and assess effect of medication advice. INTERVENTION: The patients were randomized to an intervention or control group. Medication reviews were made by one specialist in clinical pharmacology and one in cardiology. Symptoms related to heart failure or adverse reactions to cardiovascular drugs were recorded using a questionnaire. Quality of life and activities of daily living (ADL) were assessed and follow-ups performed after 2 weeks and 3 months. Outcome measures were changes of drug therapy and the global scores computed from symptoms scales. RESULTS: Eighty patients were randomized. They had a mean age of 87 years and their average number of drugs was 9.6. Changed drug therapy was suggested in 40 patients and the advice was followed by the responsible physicians in 19 patients. The physicians mostly followed advice for changed furosemide therapy but not for introducing an ACE-inhibitor, probably due to uncertain diagnosis and need for follow-up after initiation of such therapy. No significant changes from baseline to later follow-up were found in the mean total scores of any questionnaire. CONCLUSION: Intervention did not affect cardiovascular symptoms. Drug revisions should involve more than one class of drugs in order to be cost-effective.
机译：目的：研究疗养院中患有心血管疾病（心力衰竭，心肌梗塞，心绞痛，高渗或心脏瓣膜疾病）的患者的药物治疗，并评估药物治疗建议的效果。干预措施：将患者随机分为干预组或对照组。药物审查由一名临床药理学专家和一名心脏病学专家进行。使用问卷调查与心力衰竭或心血管药物不良反应相关的症状。评估生活质量和日常生活活动（ADL），并在2周和3个月后进行随访。结果指标是药物治疗的改变和根据症状量表计算的总体得分。结果：80例患者被随机分组​​。他们的平均年龄为87岁，平均毒品数量为9.6。建议40例患者改用药物治疗，19例患者的负责医师遵循该建议。多数情况下，由于不确定的诊断以及开始此类治疗后需要随访，医师们大多遵循有关改变速尿疗法的建议，而不是引入ACE抑制剂。从基线到以后的随访中，任何调查问卷的平均总得分均未见明显变化。结论：干预并未影响心血管症状。为了提高成本效益，药物修订应涉及不止一类药物。

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