{"id":11020,"date":"2019-05-31T15:46:13","date_gmt":"2019-05-31T08:46:13","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=11020"},"modified":"2025-01-08T23:23:55","modified_gmt":"2025-01-08T16:23:55","slug":"cuoc-chien-chong-lai-polypharmacy","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/cuoc-chien-chong-lai-polypharmacy\/","title":{"rendered":"Cu\u1ed9c chi\u1ebfn ch\u1ed1ng l\u1ea1i polypharmacy"},"content":{"rendered":"<p><em><strong>Theo Namudinsider<\/strong><\/em><\/p>\n<p><em><strong>Polypharmacy<\/strong>\u00a0l\u00e0 kh\u00e1i ni\u1ec7m ch\u1ec9 vi\u1ec7c b\u1ec7nh nh\u00e2n ph\u1ea3i s\u1eed d\u1ee5ng nhi\u1ec1u thu\u1ed1c kh\u00e1c nhau \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb cho m\u1ed9t b\u1ec7nh nh\u00e2n. T\u1ef7 l\u1ec7 Polypharmacy \u1edf nh\u1eefng ng\u01b0\u1eddi l\u1edbn tu\u1ed5i \u0111ang \u1edf m\u1ee9c cao nh\u1ea5t t\u1eeb tr\u01b0\u1edbc t\u1edbi nay, khi\u1ebfn ch\u00fang ta c\u1ea7n ph\u1ea3i t\u1eadp trung v\u00e0o vi\u1ec7c gi\u1ea3m b\u1edbt c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00f4ng ph\u00f9 h\u1ee3p. C\u00e1c h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb d\u1ef1a tr\u00ean b\u1eb1ng ch\u1ee9ng c\u1ee5 th\u1ec3 l\u00e0 th\u1ef1c s\u1ef1 c\u1ea7n thi\u1ebft gi\u00fap ch\u00fang ta v\u01b0\u1ee3t qua c\u00e1c r\u00e0o c\u1ea3n \u0111\u1ec3 c\u00f3 th\u1ec3 c\u1eaft gi\u1ea3m k\u00ea \u0111\u01a1n m\u1ed9t lo\u1ea1i thu\u1ed1c.<\/em><\/p>\n<figure class=\"wp-block-image\"><img decoding=\"async\" class=\"wp-image-17210\" src=\"https:\/\/namudinsider.com\/wp-content\/uploads\/2019\/03\/1076846_twitter-18.png\" sizes=\"(max-width: 580px) 100vw, 580px\" srcset=\"https:\/\/namudinsider.com\/wp-content\/uploads\/2019\/03\/1076846_twitter-18.png 580w, https:\/\/namudinsider.com\/wp-content\/uploads\/2019\/03\/1076846_twitter-18-150x99.png 150w, https:\/\/namudinsider.com\/wp-content\/uploads\/2019\/03\/1076846_twitter-18-300x199.png 300w, https:\/\/namudinsider.com\/wp-content\/uploads\/2019\/03\/1076846_twitter-18-280x185.png 280w\" alt=\"\" \/><\/figure>\n<p>David Alldred, m\u1ed9t nh\u00e0 nghi\u00ean c\u1ee9u v\u1ec1 s\u1eed d\u1ee5ng thu\u1ed1c an to\u00e0n t\u1ea1i \u0110\u1ea1i h\u1ecdc Leeds, b\u00e0i \u0111\u0103ng tr\u00ean twitter c\u1ee7a anh \u1ea5y v\u1ec1 \u0111\u01a1n thu\u1ed1c c\u1ee7a m\u1ed9t b\u1ec7nh nh\u00e2n \u0111\u00e3 thu \u0111\u01b0\u1ee3c h\u01a1n 270.000 l\u01b0\u1ee3t hi\u1ec3n th\u1ecb, 3.600 l\u01b0\u1ee3t th\u00edch v\u00e0 1.100 l\u01b0\u1ee3t chia s\u1ebb, David bi\u1ebft r\u1eb1ng m\u00ecnh \u0111\u00e3 t\u1ea1o n\u00ean nh\u1eefng t\u00e1c \u0111\u1ed9ng \u0111\u00e1ng k\u1ec3 l\u00ean c\u00e1c nh\u00e2n vi\u00ean y t\u1ebf, b\u1ec7nh nh\u00e2n v\u00e0 c\u1ea3 c\u00f4ng ch\u00fang.<\/p>\n<p>D\u00f2ng twitter n\u00f3i v\u1ec1 vi\u1ec7c xem x\u00e9t l\u1ea1i \u0111\u01a1n thu\u1ed1c c\u1ee7a m\u1ed9t b\u1ec7nh nh\u00e2n 92 tu\u1ed5i, ng\u01b0\u1eddi \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n d\u00f9ng ch\u00edn lo\u1ea1i thu\u1ed1c m\u1ed7i ng\u00e0y nh\u01b0ng \u0111\u00e3 kh\u00f4ng d\u00f9ng b\u1ea5t c\u1ee9 lo\u1ea1i n\u00e0o trong s\u1ed1 \u0111\u00f3 v\u00ec s\u1ee3 t\u00e1c d\u1ee5ng ph\u1ee5.<\/p>\n<p>\u201cM\u1ed9t D\u01b0\u1ee3c s\u0129 \u0111\u00e3 n\u00f3i chuy\u1ec7n v\u1edbi b\u1ec7nh nh\u00e2n n\u00e0y v\u00e0 h\u1ecd \u0111\u00e3 \u0111i \u0111\u1ebfn th\u1ed1ng nh\u1ea5t c\u00f9ng v\u1edbi b\u00e1c s\u0129 \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u1ec7nh nh\u00e2n, gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng thu\u1ed1c s\u1eed d\u1ee5ng xu\u1ed1ng c\u00f2n hai m\u1ed7i ng\u00e0y\u201d, theo gi\u1ea3i th\u00edch c\u1ee7a Alldred. \u0110i\u1ec1u n\u00e0y \u0111\u00e3 gi\u1ea3m g\u00e1nh n\u1eb7ng thu\u1ed1c s\u1eed d\u1ee5ng h\u00e0ng tu\u1ea7n t\u1eeb\u00a0<strong>77 xu\u1ed1ng 14 vi\u00ean<\/strong>, v\u00e0 t\u1ea1o ra h\u00ecnh \u1ea3nh \u1ea5n t\u01b0\u1ee3ng tr\u00ean twitter c\u1ee7a Alldred, \u0111i\u1ec1u n\u00e0y \u0111\u00e3 g\u00e2y ra m\u1ed9t cu\u1ed9c tranh lu\u1eadn qu\u1ed1c t\u1ebf v\u1ec1 vi\u1ec7c c\u1eaft gi\u1ea3m s\u1eed d\u1ee5ng m\u1ed9t thu\u1ed1c.<\/p>\n<p>Cu\u1ed9c tranh lu\u1eadn tr\u00ean Twitter ph\u1ea3n \u00e1nh s\u1ef1 quan t\u00e2m c\u1ee7a to\u00e0n th\u1ebf gi\u1edbi v\u1edbi vi\u1ec7c c\u1eaft gi\u1ea3m thu\u1ed1c v\u00e0 \u0111ang nhanh ch\u00f3ng nh\u1eadn \u0111\u01b0\u1ee3c nhi\u1ec1u h\u01a1n s\u1ef1 quan t\u00e2m. H\u1ec7 th\u1ed1ng \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 gi\u00fap c\u1eaft gi\u1ea3m thu\u1ed1c \u0111\u00e3 c\u00f3 \u1edf Canada, \u00dac v\u00e0 m\u1ed9t m\u1ea1ng l\u01b0\u1edbi c\u0169ng \u0111ang \u0111\u01b0\u1ee3c x\u00e2y d\u1ef1ng \u1edf Anh. B\u01b0\u1edbc \u0111i n\u00e0y nh\u1eb1m n\u00e2ng cao h\u1ed3 s\u01a1 c\u1eaft gi\u1ea3m s\u1eed d\u1ee5ng thu\u1ed1c, gi\u1ea3i quy\u1ebft m\u1ee9c \u0111\u1ed9 k\u00ea \u0111\u01a1n nhi\u1ec1u thu\u1ed1c \u0111ang ng\u00e0y c\u00e0ng t\u0103ng hi\u1ec7n nay, \u0111i\u1ec1u n\u00e0y \u0111\u00e3 th\u00fac \u0111\u1ea9y ban h\u00e0nh c\u00e1c ch\u00ednh s\u00e1ch qu\u1ed1c gia \u1edf Anh, Scotland v\u00e0 x\u1ee9 Wales, c\u0169ng nh\u01b0 ph\u1ea7n \u0111\u1ea7u ti\u00ean trong h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb k\u00ea \u0111\u01a1n v\u1edbi nhi\u1ec1u thu\u1ed1c c\u1ee7a Vi\u1ec7n Y t\u1ebf v\u00e0 Ch\u0103m s\u00f3c S\u1ee9c kh\u1ecfe (NICE) n\u0103m 2017.<\/p>\n<p>M\u1eb7c d\u00f9 k\u00ea \u0111\u01a1n nhi\u1ec1u thu\u1ed1c c\u00f3 th\u1ec3 ph\u00f9 h\u1ee3p, nh\u01b0ng n\u00f3 c\u0169ng c\u00f3 th\u1ec3 \u0111em l\u1ea1i nhi\u1ec1u v\u1ea5n \u0111\u1ec1, g\u00f3p ph\u1ea7n g\u00e2y ra c\u00e1c ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i c\u1ee7a thu\u1ed1c ch\u1eb3ng h\u1ea1n nh\u01b0 t\u00ecnh tr\u1ea1ng suy s\u1ee5p, gi\u1ea3m nh\u1eadn th\u1ee9c, kh\u00f4ng tu\u00e2n th\u1ee7, ph\u1ea3i nh\u1eadp vi\u1ec7n v\u00e0 th\u1eadm ch\u00ed t\u1eed vong. S\u1ed1 ng\u01b0\u1eddi gi\u00e0 \u1edf Anh \u0111ang d\u00f9ng n\u0103m lo\u1ea1i thu\u1ed1c k\u00ea \u0111\u01a1n ho\u1eb7c kh\u00f4ng k\u00ea \u0111\u01a1n tr\u1edf l\u00ean \u0111\u00e3 t\u0103ng g\u1ea5p b\u1ed1n l\u1ea7n trong hai th\u1eadp k\u1ef7 qua, t\u1eeb 12% \u0111\u1ebfn 49%. Tuy nhi\u00ean, Anh kh\u00f4ng ph\u1ea3i l\u00e0 tr\u01b0\u1eddng h\u1ee3p duy nh\u1ea5t \u2013 nghi\u00ean c\u1ee9u \u1edf Hoa K\u1ef3 v\u00e0 \u00dac c\u0169ng \u0111\u01b0a ra nh\u1eefng con s\u1ed1 th\u1ed1ng k\u00ea t\u01b0\u01a1ng t\u1ef1 \u1edf ng\u01b0\u1eddi gi\u00e0, v\u1edbi s\u1ed1 l\u01b0\u1ee3ng thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng t\u0103ng theo \u0111\u1ed9 tu\u1ed5i.<\/p>\n<p>M\u1ed9t trong nh\u1eefng l\u00fd do t\u1ea1i sao k\u00ea \u0111\u01a1n nhi\u1ec1u thu\u1ed1c \u0111ang tr\u1edf n\u00ean ph\u1ed5 bi\u1ebfn l\u00e0 do c\u00f3 v\u00f4 s\u1ed1 h\u01b0\u1edbng d\u1eabn l\u00e2m s\u00e0ng cho c\u00f9ng m\u1ed9t tr\u01b0\u1eddng h\u1ee3p b\u00eanh l\u00ed, Alldred gi\u1ea3i th\u00edch. \u0110\u1ed1i v\u1edbi m\u1ed9t b\u1ec7nh nh\u00e2n m\u1eafc hen suy\u1ec5n, ti\u1ec3u \u0111\u01b0\u1eddng v\u00e0 vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p, m\u1ed7i h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb l\u1ea1i khuy\u1ebfn c\u00e1o t\u1ea7m ba ho\u1eb7c b\u1ed1n lo\u1ea1i thu\u1ed1c, v\u00ec v\u1eady b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 nhanh ch\u00f3ng ph\u1ea3i s\u1eed d\u1ee5ng h\u00e0ng ch\u1ee5c lo\u1ea1i thu\u1ed1c tr\u1edf l\u00ean. Th\u1eadt kh\u00f3 kh\u0103n khi b\u1ea1n ph\u1ea3i \u0111i\u1ec1u tr\u1ecb cho m\u1ed9t b\u1ec7nh nh\u00e2n m\u1eafc nhi\u1ec1u b\u1ec7nh v\u00e0 c\u1ea7n s\u1eed d\u1ee5ng nhi\u1ec1u lo\u1ea1i thu\u1ed1c kh\u00e1c nhau: \u0111\u00e2u v\u1edbi l\u00e0 m\u1ee5c \u0111\u00edch c\u1ee7a vi\u1ec7c c\u1eaft gi\u1ea3m thu\u1ed1c?<\/p>\n<p><strong>Ph\u00e1 v\u1ee1 c\u00e1c r\u00e0o c\u1ea3n<\/strong><\/p>\n<p>Duncan Petty, nh\u1eefng ng\u01b0\u1eddi k\u00ea \u0111\u01a1n kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o c\u0169ng bi\u1ebft lo\u1ea1i thu\u1ed1c n\u00e0o g\u00e2y h\u1ea1i, hi\u1ec7n \u00f4ng \u0111ang d\u00e0nh th\u1eddi gian \u0111\u1ec3 nghi\u00ean c\u1ee9u t\u1ed1i \u01b0u h\u00f3a thu\u1ed1c t\u1ea1i \u0110\u1ea1i h\u1ecdc T\u1ed5ng h\u1ee3p \u0111\u1ed3ng th\u1eddi v\u1edbi c\u00f4ng vi\u1ec7c ch\u00ednh c\u1ee7a \u00f4ng l\u00e0 \u0111\u00e1nh gi\u00e1 thu\u1ed1c trong th\u1ef1c h\u00e0nh n\u00f3i chung. \u201cCh\u00fang t\u00f4i c\u00f3 m\u1ed9t s\u1ed1 b\u1eb1ng ch\u1ee9ng cho c\u00e1c lo\u1ea1i thu\u1ed1c ri\u00eang l\u1ebb, nh\u01b0ng c\u00f3 r\u1ea5t \u00edt b\u1eb1ng ch\u1ee9ng li\u00ean quan \u0111\u1ebfn s\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c nhau ho\u1eb7c k\u00ea \u0111\u01a1n nhi\u1ec1u thu\u1ed1c v\u1edbi c\u00e1c t\u00e1c d\u1ee5ng x\u1ea5u g\u00e2y nh\u1eadp vi\u1ec7n hay suy s\u1ee5p \u1edf b\u1ec7nh nh\u00e2n\u201d.<\/p>\n<p>C\u00f4ng vi\u1ec7c c\u1ee7a Petty t\u1eadp trung v\u00e0o nh\u1eefng ng\u01b0\u1eddi gi\u00e0 y\u1ebfu. Nhi\u1ec1u b\u1ec7nh nh\u00e2n m\u00e0 \u00f4ng quan s\u00e1t \u0111\u00e3 \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh ng\u1eebng s\u1eed d\u1ee5ng thu\u1ed1c. \u201cKhi ch\u00fang t\u00f4i \u0111\u1ebfn th\u0103m m\u1ed9t ng\u01b0\u1eddi n\u00e0o \u0111\u00f3 t\u1ea1i nh\u00e0 c\u1ee7a h\u1ecd, h\u1ecd c\u00f3 r\u1ea5t nhi\u1ec1u thu\u1ed1c\u201d, anh \u1ea5y n\u00f3i. \u201cV\u00ec v\u1eady, \u0111i\u1ec1u quan tr\u1ecdng l\u00e0 vi\u1ec7c gi\u00fap b\u1ec7nh nh\u00e2n ng\u1eebng s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00f4ng c\u1ea7n thi\u1ebft v\u00e0 th\u01b0\u1eddng xuy\u00ean ki\u1ec3m tra \u0111\u1ec3 ch\u1eafc r\u1eb1ng h\u1ecd ti\u1ebfp t\u1ee5c \u0111\u01b0\u1ee3c an to\u00e0n v\u1edbi vi\u1ec7c \u0111i\u1ec1u tr\u1ecb hi\u1ec7n t\u1ea1i\u201d.<\/p>\n<p>\u0110\u1ec3 l\u00e0m \u0111i\u1ec1u n\u00e0y, d\u01b0\u1ee3c s\u0129 c\u1ea7n ph\u1ea3i hi\u1ec3u c\u00e1c r\u00e0o c\u1ea3n \u0111\u1ec3 c\u1eaft gi\u1ea3m m\u1ed9t thu\u1ed1c, bao g\u1ed3m s\u1ef1 thi\u1ebfu nh\u1eadn th\u1ee9c, s\u1ee9c \u00ec, lo s\u1ee3 v\u1edbi nh\u1eefng t\u00e1c d\u1ee5ng ti\u00eau c\u1ef1c c\u1ee7a thu\u1ed1c (xem B\u1ea3ng 1), s\u1ef1 ph\u1ee9c t\u1ea1p c\u00f9ng v\u1edbi \u0111\u00f3 l\u00e0 kh\u1ed1i l\u01b0\u1ee3ng c\u00f4ng vi\u1ec7c t\u0103ng l\u00ean do vi\u1ec7c d\u1eebng thu\u1ed1c, \u0111\u1eb7c bi\u1ec7t l\u00e0 n\u1ebfu n\u00f3 kh\u00f4ng g\u00e2y ra b\u1ea5t k\u1ef3 t\u00e1c h\u1ea1i n\u00e0o.<\/p>\n<p><strong>B\u1ea3ng 1: C\u00e2n nh\u1eafc v\u1ec1 ph\u00e1p l\u00fd<\/strong><\/p>\n<p>\u00d3rla Kelly, m\u1ed9t d\u01b0\u1ee3c s\u0129 v\u00e0 \u0111\u1ed1i t\u00e1c t\u1ea1i Cantillons Solicitor \u1edf Cork, Ireland, th\u1eeba nh\u1eadn r\u1eb1ng nh\u1eefng ng\u01b0\u1eddi k\u00ea \u0111\u01a1n c\u00f3 th\u1ec3 c\u00f3 nh\u1eefng b\u0103n kho\u0103n trong vi\u1ec7c c\u1eaft gi\u1ea3m s\u1eed d\u1ee5ng thu\u1ed1c. \u0110i\u1ec1u n\u00e0y c\u00f3 ngh\u0129a l\u00e0 b\u1ea1n \u0111\u01b0\u1ee3c ph\u00e9p so s\u00e1nh v\u1edbi c\u00e1c \u0111\u1ed3ng nghi\u1ec7p v\u00e0 h\u1ecfi xem li\u1ec7u h\u1ecd c\u00f3 l\u00e0m nh\u01b0 v\u1eady trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y kh\u00f4ng.<\/p>\n<p>Vi\u1ec7c thi\u1ebfu b\u1eb1ng ch\u1ee9ng ho\u1eb7c s\u1ef1 h\u01b0\u1edbng d\u1eabn c\u1ee5 th\u1ec3 kh\u00f4ng nh\u1ea5t thi\u1ebft l\u00e0 r\u00e0o c\u1ea3n \u0111\u1ed1i v\u1edbi vi\u1ec7c c\u1eaft gi\u1ea3m s\u1eed d\u1ee5ng thu\u1ed1c, Kelly n\u00f3i, v\u00e0 kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng n\u00f3 nh\u01b0 m\u1ed9t m\u1ed9t l\u1eddi b\u00e0o ch\u1eefa. \u201cB\u1ea1n kh\u00f4ng c\u1ea7n ph\u1ea3i l\u00e0m g\u00ec \u0111\u00f3 kh\u00e1c bi\u1ec7t \u0111\u1ec3 c\u1eaft gi\u1ea3m thu\u1ed1c c\u1ea3; b\u1ea1n ch\u1ec9 c\u1ea7n k\u00ea \u0111\u01a1n h\u1ee3p l\u00fd v\u00e0 ph\u00f9 h\u1ee3p theo h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb n\u1ebfu c\u00f3\u201d.<\/p>\n<p>Kelly nh\u1ea5n m\u1ea1nh t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c gi\u00fap b\u1ec7nh nh\u00e2n n\u1eafm \u0111\u01b0\u1ee3c c\u00e1c th\u00f4ng tin c\u1ea7n thi\u1ebft. \u201cB\u1ea1n c\u1ea7n n\u00f3i v\u1edbi b\u1ec7nh nh\u00e2n v\u1ec1 c\u00e1c l\u1ef1a ch\u1ecdn thay th\u1ebf v\u00e0 nh\u1eefng \u0111i\u1ec1u ch\u1ec9nh c\u1ea7n thi\u1ebft cho b\u1ec7nh nh\u00e2n\u201d. \u0110i\u1ec1u n\u00e0y c\u00f3 ngh\u0129a l\u00e0 gi\u00fap b\u1ec7nh nh\u00e2n hi\u1ec3u nh\u1eefng g\u00ec c\u00f3 th\u1ec3 x\u1ea3y ra n\u1ebfu ng\u1eebng thu\u1ed1c v\u00e0 li\u1ec7u c\u00f3 xu\u1ea5t hi\u1ec7n b\u1ea5t k\u1ef3 t\u00e1c d\u1ee5ng x\u1ea5u n\u00e0o hay kh\u00f4ng. \u201cB\u1ea1n c\u00f3 th\u1ec3 tho\u00e1t ra kh\u1ecfi vi\u1ec7c k\u00ea \u0111\u01a1n m\u1ed9t c\u00e1ch m\u00e1y m\u00f3c: n\u1ebfu c\u00f3 h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb, h\u00e3y l\u01b0u \u00fd v\u00e0 \u00e1p d\u1ee5ng n\u00f3 ho\u1eb7c n\u00eau l\u00fd do t\u1ea1i sao b\u1ea1n kh\u00f4ng \u00e1p d\u1ee5ng h\u01b0\u1edbng d\u1eabn n\u00e0y\u201d, Kelly n\u00f3i.<\/p>\n<p>Kelly n\u00f3i th\u00eam r\u1eb1ng ng\u01b0\u1eddi k\u00ea \u0111\u01a1n c\u0169ng ph\u1ea3i xem x\u00e9t c\u00e1c r\u1ee7i ro ph\u00e1p l\u00fd khi ti\u1ebfp t\u1ee5c ch\u1ec9 \u0111\u1ecbnh c\u00e1c thu\u1ed1c kh\u00f4ng ph\u00f9 h\u1ee3p cho b\u1ec7nh nh\u00e2n.<\/p>\n<p>B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u00f3 m\u1ed9t t\u1ec7p \u0111\u00ednh k\u00e8m v\u1edbi m\u00e1y t\u00ednh b\u1ea3ng c\u1ee7a h\u1ecd, \u0111\u1eb7c bi\u1ec7t n\u1ebfu h\u1ecd \u0111\u01b0\u1ee3c th\u00f4ng b\u00e1o r\u1eb1ng m\u00ecnh s\u1ebd c\u1ea7n ph\u1ea3i d\u00f9ng ch\u00fang su\u1ed1t \u0111\u1eddi. \u201cC\u00e0ng \u0111\u01b0\u1ee3c nh\u1eafc nh\u1edf nhi\u1ec1u, b\u1ec7nh nh\u00e2n c\u00e0ng \u00edt mu\u1ed1n b\u1ecf thu\u1ed1c, ngay c\u1ea3 khi ch\u00fang t\u00f4i n\u00f3i v\u1edbi h\u1ecd r\u1eb1ng b\u1eb1ng ch\u1ee9ng l\u00e2m s\u00e0ng thu \u0111\u01b0\u1ee3c \u0111\u00e3 thay \u0111\u1ed5i ho\u1eb7c v\u1ec1 nh\u1eefng t\u00e1c h\u1ea1i ti\u1ec1m t\u00e0ng c\u1ee7a thu\u1ed1c\u201d, Petty n\u00f3i.<\/p>\n<p>Nina Barnett, d\u01b0\u1ee3c s\u0129 t\u01b0 v\u1ea5n t\u1ea1i\u00a0<strong>NHS Specialist Pharmacy Service and London North West University Healthcare NHS Trust,<\/strong>\u00a0n\u00f3i r\u1eb1ng c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng \u0111\u00f4i khi lo l\u1eafng v\u1ec1 vi\u1ec7c b\u1ec7nh nh\u00e2n s\u1ebd ph\u1ea3n \u1ee9ng th\u1ebf n\u00e0o n\u1ebfu h\u1ecd n\u00f3i v\u1ec1 v\u1ea5n \u0111\u1ec1 n\u00e0y. B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 lo ng\u1ea1i r\u1eb1ng h\u1ec7 th\u1ed1ng ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe kh\u00f4ng th\u1ec3 \u0111\u1ee7 kh\u1ea3 n\u0103ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb cho h\u1ecd ho\u1eb7c v\u00ec \u0111\u00e3 gi\u00e0, h\u1ecd s\u1ebd kh\u00f4ng nh\u1eadn \u0111\u01b0\u1ee3c \u0111\u01b0\u1ee3c nh\u1eefng ch\u0103m s\u00f3c ph\u00f9 h\u1ee3p. B\u1ec7nh nh\u00e2n c\u0169ng c\u00f3 th\u1ec3 \u0111\u1eb7t c\u00e2u h\u1ecfi l\u00e0 t\u1ea1i sao thu\u1ed1c l\u1ea1i \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n ngay t\u1eeb b\u01b0\u1edbc \u0111\u1ea7u ti\u00ean.<\/p>\n<p>Ng\u01b0\u1eddi k\u00ea \u0111\u01a1n c\u0169ng c\u1ea7n xem x\u00e9t v\u1ec1 tu\u1ed5i th\u1ecd, n\u00f3 c\u00f3 th\u1ec3 kh\u00f3 d\u1ef1 \u0111o\u00e1n v\u00e0 r\u1ea5t kh\u00f3 n\u00f3i. \u201cNhi\u1ec1u lo\u1ea1i thu\u1ed1c c\u1ea7n c\u00f3 th\u1eddi gian \u0111\u1ec3 thu \u0111\u01b0\u1ee3c l\u1ee3i \u00edch khi s\u1eed d\u1ee5ng\u201d, Alldred n\u00f3i. \u201cN\u1ebfu ph\u1ea3i m\u1ea5t ba ho\u1eb7c b\u1ed1n n\u0103m \u0111\u1ec3 m\u1ed9t lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 \u0111em l\u1ea1i l\u1ee3i \u00edch v\u00e0 b\u1ec7nh nh\u00e2n \u0111\u00f3 ch\u1ec9 c\u00f3 th\u1ec3 s\u1ed1ng th\u00eam m\u1ed9t n\u0103m, h\u1ecd s\u1ebd kh\u00f4ng \u0111\u01b0\u1ee3c h\u01b0\u1edfng l\u1ee3i v\u00e0 c\u00f3 th\u1ec3 b\u1ea1n \u0111ang \u0111\u1ec3 b\u1ec7nh nh\u00e2n c\u1ee7a m\u00ecnh ph\u1ea3i ph\u1ea3i m\u1ea1o hi\u1ec3m\u201d.<\/p>\n<p>C\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng c\u0169ng c\u00f3 th\u1ec3 kh\u00f3 gi\u1ea3i th\u00edch nh\u1eefng l\u1ee3i \u00edch v\u00e0 r\u1ee7i ro c\u1ee7a vi\u1ec7c d\u00f9ng thu\u1ed1c. \u201cC\u00f3 th\u1ec3 gi\u1ea3i th\u00edch c\u00e1c c\u01a1 s\u1edf b\u1eb1ng ch\u1ee9ng l\u00e0 m\u1ed9t th\u00e1ch th\u1ee9c th\u1ef1c s\u1ef1\u201d, Alldred n\u00f3i, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i, nh\u00f3m b\u1ec7nh nh\u00e2n v\u1eabn \u0111ang thi\u1ebfu \u0111i c\u00e1c b\u1eb1ng ch\u1ee9ng c\u1ee5 th\u1ec3. Ch\u00fang t\u00f4i c\u1ea7n ph\u1ea3i trung th\u1ef1c v\u1edbi b\u1ec7nh nh\u00e2n v\u1ec1 \u0111i\u1ec1u \u0111\u00f3 v\u00e0 cho h\u1ecd bi\u1ebft r\u1eb1ng \u201cch\u00fang t\u00f4i kh\u00f4ng th\u1ef1c s\u1ef1 bi\u1ebft ch\u1eafc \u0111\u01b0\u1ee3c nh\u1eefng l\u1ee3i \u00edch c\u1ee7a thu\u1ed1c trong \u0111\u1ed9 tu\u1ed5i c\u1ee7a b\u1ea1n\u201d.<\/p>\n<p>\u0110\u1ec3 gi\u1ea3i quy\u1ebft m\u1ed9t s\u1ed1 th\u00e1ch th\u1ee9c n\u00e0y, nh\u00f3m c\u1ee7a Alldred \u0111ang nghi\u00ean c\u1ee9u vi\u1ec7c d\u01b0\u1ee3c s\u0129 s\u1ebd k\u00ea \u0111\u01a1n v\u00e0 ch\u0103m s\u00f3c t\u1ea1i nh\u00e0 cho b\u1ec7nh nh\u00e2n. L\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a nghi\u00ean c\u1ee9u, d\u01b0\u1ee3c s\u0129 s\u1ebd ph\u00e1t tri\u1ec3n c\u00e1c k\u1ebf ho\u1ea1ch s\u1eed d\u1ee5ng thu\u1ed1c v\u00e0 x\u00e1c \u0111\u1ecbnh c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00f4ng c\u00f2n c\u1ea7n thi\u1ebft ho\u1eb7c khi ph\u00e2n t\u00edch l\u1ee3i \u00edch v\u00e0 r\u1ee7i ro m\u00e0 thu\u1ed1c \u0111em l\u1ea1i l\u00e0 kh\u00f4ng kh\u1ea3 quan. \u201cN\u1ebfu c\u00f3 th\u1ec3 ch\u1ee9ng minh \u0111\u01b0\u1ee3c vai tr\u00f2 c\u1ee7a d\u01b0\u1ee3c s\u0129 trong vi\u1ec7c k\u00ea \u0111\u01a1n thu\u1ed1c t\u1ea1i nh\u00e0 th\u00ec \u0111i\u1ec1u n\u00e0y s\u1ebd c\u00f3 t\u00e1c \u0111\u1ed9ng l\u1edbn \u0111\u1ebfn th\u1ef1c ti\u1ec5n v\u00e0 c\u00e1c ch\u00ednh s\u00e1ch\u201d, theo \u00f4ng Alldred, \u00f4ng d\u1ef1 \u0111o\u00e1n ch\u00fang ta s\u1ebd c\u00f3 \u0111\u01b0\u1ee3c c\u00e2u tr\u1ea3 l\u1eddi v\u00e0o n\u0103m 2020.<\/p>\n<p><strong>T\u1ea1i sao thu\u1ed1c \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n<\/strong><\/p>\n<p>Bi\u1ebft \u0111\u01b0\u1ee3c l\u00fd do t\u1ea1i sao m\u1ed9t lo\u1ea1i thu\u1ed1c l\u1ea1i \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 quan tr\u1ecdng \u0111\u1ec3 c\u1eaft gi\u1ea3m s\u1eed d\u1ee5ng thu\u1ed1c, theo Barbara Farrell, m\u1ed9t d\u01b0\u1ee3c s\u0129 l\u00e2m s\u00e0ng t\u1ea1i B\u1ec7nh vi\u1ec7n L\u00e3o khoa Bruy\u00e8re \u1edf Ottawa, Canada, \u0111\u1ed3ng th\u1eddi l\u00e0 m\u1ed9t nh\u00e0 khoa h\u1ecdc nghi\u00ean c\u1ee9u t\u1ea1i Vi\u1ec7n nghi\u00ean c\u1ee9u Bruy\u00e8re.<\/p>\n<p>Farrell l\u00e0 ch\u1ee7 t\u1ecbch \u1ee7y ban cung c\u1ea5p d\u1ecbch v\u1ee5 gi\u00e1o d\u1ee5c ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe cho M\u1ea1ng l\u01b0\u1edbi c\u1eaft gi\u1ea3m s\u1eed d\u1ee5ng thu\u1ed1c \u1edf Canada (CaDeN), \u0111ang k\u00eau g\u1ecdi c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng ghi l\u1ea1i l\u00fd do s\u1eed d\u1ee5ng m\u1ed9t lo\u1ea1i thu\u1ed1c v\u00e0 th\u1eddi gian d\u1ef1 \u0111\u1ecbnh s\u1eed d\u1ee5ng. \u1ede Canada, t\u01b0\u01a1ng t\u1ef1 nh\u01b0 Hoa K\u1ef3, b\u1ec7nh nh\u00e2n th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe t\u1eeb m\u1ed9t s\u1ed1 c\u01a1 s\u1edf m\u00e0 thi\u1ebfu s\u1ef1 li\u00ean k\u1ebft c\u1ea7n thi\u1ebft. \u201cB\u1ea1n kh\u00f4ng ghi ch\u00fa l\u1ea1i c\u00e1c th\u00f4ng tin c\u1ea7n thi\u1ebft v\u00e0 b\u1ec7nh nh\u00e2n kh\u00f4ng nh\u1edb t\u1ea1i sao [thu\u1ed1c] l\u1ea1i \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n. V\u00ec v\u1eady, b\u1ea1n s\u1ebd c\u1ea3m th\u1ea5y lo l\u1eafng khi y\u00eau c\u1ea7u b\u1ec7nh nh\u00e2n ng\u1eebng d\u00f9ng thu\u1ed1c b\u1edfi v\u00ec b\u1ea1n kh\u00f4ng bi\u1ebft t\u1ea1i sao h\u1ecd l\u1ea1i d\u00f9ng n\u00f3\u201d, Farrell gi\u1ea3i th\u00edch th\u00eam.<\/p>\n<p>\u201cCh\u00fang t\u00f4i may m\u1eafn h\u01a1n \u1edf Anh\u201d, Petty n\u00f3i. \u201cH\u1ea7u h\u1ebft c\u00e1c th\u00f4ng tin b\u1ec7nh nh\u00e2n \u0111\u1ec1u \u0111\u01b0\u1ee3c l\u01b0u l\u1ea1i trong h\u1ec7 th\u1ed1ng ch\u0103m s\u00f3c ch\u00ednh\u201d. \u0110\u1ed1i v\u1edbi m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n, \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 l\u00e0 c\u1ea7n thi\u1ebft ph\u1ea3i ghi ch\u00fa l\u1ea1i tr\u00ean gi\u1ea5y. \u201cB\u1ea1n th\u01b0\u1eddng c\u00f3 th\u1ec3 th\u01b0\u1eddng xuy\u00ean t\u00ecm th\u1ea5y m\u1ed9t c\u00e2u tr\u1ea3 l\u1eddi trong m\u1ed9t l\u00e1 th\u01b0 ho\u1eb7c trong c\u00e2u chuy\u1ec7n \u1edf \u0111\u00e2u \u0111\u00f3\u201d, Petty n\u00f3i. \u201cT\u00f4i \u0111\u00e3 t\u00ecm th\u1ea5y m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c \u0111\u00e3 b\u1eaft \u0111\u1ea7u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng t\u1eeb nhi\u1ec1u n\u0103m tr\u01b0\u1edbc v\u00ec m\u1ed9t l\u1ed7i \u0111\u00e1nh m\u00e1y trong m\u1ed9t l\u00e0 th\u01b0\u201d.<\/p>\n<p>Nhu c\u1ea7u t\u00ecm ki\u1ebfm th\u00f4ng qua h\u1ed3 s\u01a1 b\u1ec7nh nh\u00e2n n\u00eau b\u1eadt l\u00ean m\u1ed9t r\u00e0o c\u1ea3n kh\u00e1c \u0111\u1ed1i v\u1edbi vi\u1ec7c k\u00ea \u0111\u01a1n \u2013 \u0111\u00f3 l\u00e0 c\u00e1c t\u00e0i nguy\u00ean li\u00ean quan. B\u00e1c s\u0129 l\u00e2m s\u00e0ng c\u1ea7n t\u00ecm hi\u1ec3u c\u00e1c ghi ch\u00fa y t\u1ebf, tham kh\u1ea3o \u00fd ki\u1ebfn \u200b\u200bb\u1ec7nh nh\u00e2n, \u0111\u01b0a ra m\u1ed9t k\u1ebf ho\u1ea1ch sau \u0111\u00f3 cung c\u1ea5p c\u00e1c h\u1ed7 tr\u1ee3 c\u1ea7n thi\u1ebft v\u00e0 ti\u1ebfp t\u1ee5c theo d\u00f5i. \u201cS\u1ebd l\u00e0 r\u1ea5t t\u1ed1n th\u1eddi gian \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 thu\u1ed1c \u0111\u00fang c\u00e1ch\u201d, Petty n\u00f3i. \u201c\u00cdt nh\u1ea5t ph\u1ea3i m\u1ea5t n\u1eeda ti\u1ebfng \u0111\u1ebfn 45 ph\u00fat\u201d.<\/p>\n<p>Alldred cho bi\u1ebft th\u00eam, c\u00e1c tr\u01b0\u1eddng h\u1ee3p ph\u1ee9c t\u1ea1p h\u01a1n, v\u00ed d\u1ee5, b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n thu\u1ed1c opioid ho\u1eb7c thu\u1ed1c benzodiazepin, vi\u1ec7c t\u01b0 v\u1ea5n s\u1eed d\u1ee5ng 2 thu\u1ed1c n\u00e0y s\u1ebd kh\u00f4ng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n trong m\u1ed9t bu\u1ed5i. \u201c\u0110\u00e2y s\u1ebd l\u00e0 s\u1ef1 \u0111\u1ea7u t\u01b0 \u0111\u00fang \u0111\u1eafn c\u1ea3 v\u1ec1 th\u1eddi gian v\u00e0 ngu\u1ed3n l\u1ef1c \u0111\u1ec3 c\u00f3 th\u1ec3 l\u00e0m \u0111\u01b0\u1ee3c \u0111i\u1ec1u \u0111\u00f3. Kh\u00f4ng c\u00f3 gi\u1ea3i ph\u00e1p nhanh ch\u00f3ng n\u00e0o \u1edf \u0111\u00e2y\u201d.<\/p>\n<p><strong>Chia s\u1ebb v\u1ec1 vi\u1ec7c ra c\u00e1c quy\u1ebft \u0111\u1ecbnh<\/strong><\/p>\n<p>Barnett tin r\u1eb1ng nhi\u1ec1u r\u00e0o c\u1ea3n \u0111\u1ed1i v\u1edbi vi\u1ec7c c\u1eaft gi\u1ea3m s\u1eed d\u1ee5ng thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c kh\u1eafc ph\u1ee5c b\u1eb1ng c\u00e1ch \u0111\u1ea3m b\u1ea3o s\u1ef1 tham v\u1ea5n v\u1edbi b\u1ec7nh nh\u00e2n v\u00e0 c\u00f9ng chia s\u1ebb vi\u1ec7c \u0111\u01b0a ra c\u00e1c quy\u1ebft \u0111\u1ecbnh chung.<\/p>\n<p>C\u00f4 \u1ea5y l\u1ea5y statin l\u00e0m v\u00ed d\u1ee5 v\u00e0 g\u1ee3i \u00fd r\u1eb1ng ng\u01b0\u1eddi k\u00ea \u0111\u01a1n thu\u1ed1c c\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u cu\u1ed9c tr\u00f2 chuy\u1ec7n theo c\u00e1ch n\u00e0y: Nguy c\u01a1 b\u1ea1n g\u1eb7p ph\u1ea3i c\u00e1c c\u01a1n \u0111au tim ho\u1eb7c \u0111\u1ed9t qu\u1ef5 b\u00e2y gi\u1edd \u0111\u1ee7 cao \u0111\u1ec3 t\u00f4i ph\u1ea3i xem x\u00e9t \u0111\u1ebfn vi\u1ec7c cung c\u1ea5p cho b\u1ea1n m\u1ed9t lo\u1ea1i thu\u1ed1c l\u00e0m gi\u1ea3m nguy c\u01a1 \u0111\u00f3. B\u1ea1n \u0111\u00e3 bi\u1ebft \u0111\u01b0\u1ee3c nh\u1eefng g\u00ec v\u1ec1 statin?<\/p>\n<p>\u201cTr\u01b0\u1edbc khi b\u1ea1n n\u00f3i b\u1ea5t c\u1ee9 \u0111i\u1ec1u g\u00ec v\u1ec1 vi\u1ec7c k\u00ea \u0111\u01a1n, b\u1ea1n n\u00ean s\u1eed d\u1ee5ng t\u1eeb \u0111\u00e3 \u201cxem x\u00e9t\u201d k\u0129 l\u01b0\u1ee1ng\u201d, Barnett n\u00f3i, ng\u01b0\u1eddi \u0111\u00e3 ph\u00e1t tri\u1ec3n c\u00e1c h\u01b0\u1edbng d\u1eabn v\u1ec1 vi\u1ec7c t\u01b0 v\u1ea5n l\u1ea5y b\u1ec7nh nh\u00e2n l\u00e0m trung t\u00e2m. M\u1ed9t s\u1ed1 ng\u01b0\u1eddi s\u1ebd ch\u1ea5p nh\u1eadn l\u1eddi khuy\u00ean c\u1ee7a b\u1ea1n, nh\u1eefng ng\u01b0\u1eddi kh\u00e1c s\u1ebd c\u00f3 c\u00e1c quan ng\u1ea1i \u2013 c\u00f3 l\u1ebd h\u1ecd \u0111\u00e3 nghe n\u00f3i r\u1eb1ng statin ch\u1eefa ung th\u01b0 ho\u1eb7c ch\u00fang c\u00f3 gi\u1ebft b\u1ea1n, c\u00f4 n\u00f3i th\u00eam. \u201c\u0110\u00e2y l\u00e0 hai c\u00e1ch ti\u1ebfp c\u1eadn c\u1ef1c k\u1ef3 kh\u00e1c nhau cho c\u00f9ng m\u1ed9t lo\u1ea1i thu\u1ed1c\u201d, Barnett n\u00f3i. \u201cB\u1ea1n n\u00f3i v\u1edbi b\u1ec7nh nh\u00e2n r\u1eb1ng \u0111\u00e2y \u0111\u00e2y l\u00e0 m\u1ed9t cu\u1ed9c trao \u0111\u1ed5i, \u0111\u00e0m tho\u1ea1i ch\u1ee9 kh\u00f4ng ph\u1ea3i l\u00e0 m\u1ed9t quy \u0111\u1ecbnh b\u1eaft bu\u1ed9c. Cu\u1ed9c tr\u00f2 chuy\u1ec7n sau \u0111\u00f3 c\u00f3 th\u1ec3 chuy\u1ec3n sang th\u1ea3o lu\u1eadn v\u1ec1 th\u1eddi gian d\u00f9ng th\u1eed v\u1edbi s\u1ef1 theo d\u00f5i th\u00eam \u0111\u1ec3 ki\u1ec3m tra ch\u1eafc r\u1eb1ng thu\u1ed1c c\u00f3 ph\u00f9 h\u1ee3p v\u1edbi b\u1ec7nh nh\u00e2n kh\u00f4ng.<\/p>\n<p>Emily Reeve, m\u1ed9t nh\u00e0 nghi\u00ean c\u1ee9u t\u1ea1i \u0110\u1ea1i h\u1ecdc Sydney, \u00dac, l\u00e0 t\u00e1c gi\u1ea3 c\u1ee7a m\u1ed9t nghi\u00ean c\u1ee9u t\u00ecm hi\u1ec3u v\u1ec1 th\u00e1i \u0111\u1ed9 c\u1ee7a b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i \u0111\u1ed1i v\u1edbi vi\u1ec7c k\u00ea \u0111\u01a1n thu\u1ed1c, \u0111\u01b0\u1ee3c xu\u1ea5t b\u1ea3n v\u00e0o th\u00e1ng 10 n\u0103m 2018. C\u00f4 khuy\u00ean c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng n\u00ean th\u01b0\u1eddng xuy\u00ean th\u1ea3o lu\u1eadn v\u1ec1 vi\u1ec7c k\u00ea \u0111\u01a1n v\u1edbi b\u1ec7nh nh\u00e2n v\u00e0 k\u1ebft h\u1ee3p v\u1edbi c\u00e1c \u0111\u00e1nh gi\u00e1 v\u1ec1 s\u1ef1 ph\u00f9 h\u1ee3p c\u1ee7a thu\u1ed1c nh\u01b0 m\u1ed9t ph\u1ea7n c\u1ee7a ch\u0103m s\u00f3c th\u00f4ng th\u01b0\u1eddng. \u201cCh\u00fang t\u00f4i nh\u1eadn th\u1ea5y r\u1eb1ng b\u00eanh nh\u00e2n l\u1edbn tu\u1ed5i v\u00e0 nh\u1eefng ng\u01b0\u1eddi ch\u0103m s\u00f3c h\u1ecd kh\u00e1 c\u1edfi m\u1edf v\u1edbi vi\u1ec7c k\u00ea \u0111\u01a1n nh\u01b0ng h\u1ecd mu\u1ed1n bi\u1ebft t\u1ea1i sao n\u00ean d\u1eebng s\u1eed d\u1ee5ng m\u1ed9t lo\u1ea1i thu\u1ed1c v\u00e0 c\u0169ng mu\u1ed1n bi\u1ebft ch\u1eafc r\u1eb1ng h\u1ecd s\u1ebd nh\u1eadn \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 trong su\u1ed1t qu\u00e1 tr\u00ecnh n\u00e0y\u201d.<\/p>\n<p>Reeve \u0111\u1ec1 ngh\u1ecb r\u1eb1ng quy\u1ebft \u0111\u1ecbnh k\u00ea \u0111\u01a1n c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc ngang b\u1eb1ng v\u1edbi quy\u1ebft \u0111\u1ecbnh ng\u1eebng hay ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng m\u1ed9t lo\u1ea1i thu\u1ed1c. \u201cTi\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng thu\u1ed1c kh\u00f4ng n\u00ean xem \u0111\u00f3 l\u00e0 m\u1ed9t h\u00e0nh \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng hay m\u1eb7c \u0111\u1ecbnh\u201d, c\u00f4 n\u00f3i th\u00eam.<\/p>\n<p>Farrell \u0111\u1ed3ng \u00fd r\u1eb1ng vi\u1ec7c chia s\u1ebb th\u00f4ng tin v\u1ec1 c\u00e1c \u0111\u01a1n thu\u1ed1c l\u00e0 r\u1ea5t quan tr\u1ecdng: \u201cT\u1eadp h\u1ee3p th\u00f4ng tin v\u1ec1 ti\u1ec1n s\u1eed d\u00f9ng thu\u1ed1c c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u00f3, cung c\u1ea5p th\u00f4ng tin m\u1ed9t c\u00e1ch kh\u00e1ch quan, gi\u1ea3i th\u00edch c\u00e1c l\u1ef1a ch\u1ecdn cho b\u1ec7nh nh\u00e2n v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 [l\u1ef1a ch\u1ecdn] m\u00e0 h\u1ecd quan t\u00e2m\u201d, c\u00f4 n\u00f3i.<\/p>\n<p>Farrell n\u00f3i r\u1eb1ng ng\u01b0\u1eddi k\u00ea \u0111\u01a1n n\u00ean d\u00e0nh th\u1eddi gian \u0111\u1ec3 gi\u1ea3i th\u00edch l\u00fd do t\u1ea1i sao h\u1ecd ch\u1ec9 \u0111\u1ecbnh thu\u1ed1c n\u00e0y cho b\u1ec7nh nh\u00e2n, b\u1ec7nh nh\u00e2n s\u1ebd c\u1ea7n d\u00f9ng thu\u1ed1c trong bao l\u00e2u v\u00e0 n\u1ebfu c\u00f3 k\u1ebf ho\u1ea1ch ng\u1eebng thu\u1ed1c d\u1ea7n d\u1ea7n khi b\u1ec7nh nh\u00e2n gi\u00e0 \u0111i. \u201cKh\u00f4ng ai n\u00f3i r\u1eb1ng \u0111\u00e2y l\u00e0 l\u1ea7n cu\u1ed1i c\u00f9ng nh\u01b0ng h\u1ecd n\u00ean n\u00f3i \u0111i\u1ec1u \u0111\u00f3 cho m\u1ed7i \u0111\u01a1n thu\u1ed1c \u0111\u01b0\u1ee3c h\u1ecd k\u00ea. \u0110i\u1ec1u \u0111\u00f3 s\u1ebd \u0111\u1eb7t ra k\u1ef3 v\u1ecdng s\u1edbm \u2013 \u0111\u00e2y kh\u00f4ng ph\u1ea3i l\u00e0 thu\u1ed1c m\u00e0 t\u00f4i c\u1ea7n d\u00f9ng su\u1ed1t \u0111\u1eddi\u201d.<\/p>\n<p><strong>T\u00e0i nguy\u00ean d\u1ef1a tr\u00ean b\u1eb1ng ch\u1ee9ng<\/strong><\/p>\n<p>Petty n\u00f3i r\u1eb1ng trong khi c\u00e1c h\u01b0\u1edbng d\u1eabn c\u1eaft gi\u1ea3m s\u1eed d\u1ee5ng thu\u1ed1c tr\u00ean l\u00fd thuy\u1ebft th\u00ec nhi\u1ec1u nh\u01b0ng l\u1ea1i c\u00f3 r\u1ea5t \u00edt b\u1eb1ng ch\u1ee9ng th\u1ef1c nghi\u1ec7m, \u0111\u1eb7c bi\u1ec7t l\u00e0 t\u1eeb c\u00e1c nghi\u00ean c\u1ee9u li\u00ean quan \u0111\u1ebfn b\u1ec7nh nh\u00e2n.<\/p>\n<p>\u201cC\u00f3 v\u1ebb nh\u01b0 ch\u00fang t\u00f4i \u0111\u00e3 quy\u1ebft \u0111\u1ecbnh \u0111\u00e2y l\u00e0 \u0111i\u1ec1u t\u1ed1t nh\u1ea5t cho b\u1ec7nh nh\u00e2n m\u00e0 ch\u01b0a bao gi\u1edd h\u1ecfi \u00fd ki\u1ebfn c\u1ee7a [h\u1ecd]\u201d, \u00f4ng n\u00f3i. \u201cNgay c\u1ea3 t\u1eeb \u201cc\u1eaft gi\u1ea3m \u0111\u01a1n thu\u1ed1c\u201d \u2013 \u0111\u00f3 c\u0169ng l\u00e0 m\u1ed9t c\u1ee5m t\u1eeb th\u1eadt \u00e1m \u1ea3nh. Ch\u00fang t\u00f4i c\u1ea7n m\u1ed9t c\u1ee5m t\u1eeb m\u00e0 b\u1ec7nh nh\u00e2n th\u00edch v\u00e0 hi\u1ec3u\u201d.<\/p>\n<p>C\u00f4ng c\u1ee5 \u0111\u00e1nh gi\u00e1 thu\u1ed1c STOPP \/ START, n\u00eau b\u1eadt vi\u1ec7c k\u1ebft h\u1ee3p c\u00e1c thu\u1ed1c v\u00e0 t\u00ecnh tr\u1ea1ng c\u00f3 kh\u1ea3 n\u0103ng kh\u00f4ng ph\u00f9 h\u1ee3p v\u1edbi ng\u01b0\u1eddi gi\u00e0 y\u1ebfu, l\u00e0 \u0111i\u1ec3m kh\u1edfi \u0111\u1ea7u h\u1eefu \u00edch, Petty (xem B\u1ea3ng 2). N\u00f3 li\u1ec7t k\u00ea c\u00e1c lo\u1ea1i thu\u1ed1c m\u00e0 c\u00f3 b\u1eb1ng ch\u1ee9ng r\u00f5 r\u00e0ng. \u201cM\u1ed9t s\u1ed1 th\u1ee9 c\u00f2n thi\u1ebfu m\u00e0 ch\u00fang ta kh\u00f4ng bi\u1ebft \u2013 v\u00ed d\u1ee5 nh\u01b0 vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c trong t\u00ednh tr\u1ea1ng b\u1ec7nh nh\u00e2n c\u00f3 s\u1ee9c kho\u1ebb y\u1ebfu\u201d, \u00f4ng n\u00f3i. Quy\u1ebft \u0111\u1ecbnh kh\u00f3 kh\u0103n h\u01a1n trong th\u1ef1c t\u1ebf l\u00e0 m\u1ed9t quy\u1ebft \u0111\u1ecbnh khi ch\u00fang ta kh\u00f4ng c\u00f3 \u0111\u01b0\u1ee3c c\u00e1c b\u1eb1ng ch\u1ee9ng tr\u1ef1c ti\u1ebfp.<\/p>\n<p><strong>S\u1eed d\u1ee5ng c\u00f4ng c\u1ee5 (Tool) \u0111\u00e1nh gi\u00e1 thu\u1ed1c STOPP \/ START<\/strong><\/p>\n<p>C\u00f4ng c\u1ee5 \u0111\u00e1nh gi\u00e1 thu\u1ed1c STOPP \/ START \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 t\u00ecm ra nh\u1eefng thu\u1ed1c kh\u00f4ng ph\u00f9 h\u1ee3p g\u00e2y ra c\u00e1c ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i. STOPP (C\u00f4ng c\u1ee5 s\u00e0ng l\u1ecdc c\u00e1c \u0111\u01a1n thu\u1ed1c c\u00f3 kh\u1ea3 n\u0103ng kh\u00f4ng ph\u00f9 h\u1ee3p c\u1ee7a ng\u01b0\u1eddi l\u1edbn tu\u1ed5i) bao g\u1ed3m c\u00e1c quy t\u1eafc li\u00ean quan \u0111\u1ebfn c\u00e1c tr\u01b0\u1eddng h\u1ee3p ph\u1ed5 bi\u1ebfn nh\u1ea5t, \u00a0kh\u1ea3 n\u0103ng g\u00e2y nguy hi\u1ec3m m\u00e0 c\u00e1c \u0111\u01a1n thu\u1ed1c kh\u00f4ng ph\u00f9 h\u1ee3p \u0111em l\u1ea1i cho nh\u00f3m b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i.<\/p>\n<p>START (C\u00f4ng c\u1ee5 s\u00e0ng l\u1ecdc \u0111\u1ec3 c\u1ea3nh b\u00e1o c\u00e1c b\u00e1c s\u0129 \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u00fang) bao g\u1ed3m c\u00e1c quy t\u1eafc li\u00ean quan \u0111\u1ebfn c\u00e1c tr\u01b0\u1eddng h\u1ee3p ph\u1ed5 bi\u1ebfn v\u1ec1 k\u00ea \u0111\u01a1n thi\u1ebfu s\u00f3t.<\/p>\n<p>V\u00ed d\u1ee5 v\u1ec1 ti\u00eau ch\u00ed STOPP cho h\u1ec7 h\u00f4 h\u1ea5p bao g\u1ed3m:<\/p>\n<ul>\n<li>Theophylline \u0111\u1ec3 tr\u1ecb li\u1ec7u cho b\u1ec7nh nh\u00e2n ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (COPD) (c\u00f3 m\u1ed9t s\u1ef1 thay th\u1ebf an to\u00e0n h\u01a1n, hi\u1ec7u qu\u1ea3 h\u01a1n; nguy c\u01a1 t\u00e1c d\u1ee5ng ph\u1ee5 do ch\u1ec9 s\u1ed1 \u0111i\u1ec1u tr\u1ecb h\u1eb9p)<\/li>\n<li>Corticosteroid to\u00e0n th\u00e2n thay v\u00ec d\u00f9ng corticosteroid d\u1ea1ng h\u00edt \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb duy tr\u00ec trong \u0111i\u1ec1u tr\u1ecb COPD trong tr\u01b0\u1eddng h\u1ee3p v\u1eeba-n\u1eb7ng (ti\u1ebfp x\u00fac kh\u00f4ng c\u1ea7n thi\u1ebft d\u1eabn t\u1edbi c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 l\u00e2u d\u00e0i c\u1ee7a steroid to\u00e0n th\u00e2n);<\/li>\n<li>Ipratropium nebulised v\u1edbi b\u1ec7nh t\u0103ng nh\u00e3n \u00e1p (c\u00f3 th\u1ec3 l\u00e0m tr\u1ea7m tr\u1ecdng th\u00eam b\u1ec7nh t\u0103ng nh\u00e3n \u00e1p).<\/li>\n<\/ul>\n<p><strong>V\u00ed d\u1ee5 v\u1ec1 ti\u00eau ch\u00ed START cho h\u1ec7 h\u00f4 h\u1ea5p:<\/strong><\/p>\n<ul>\n<li>Thu\u1ed1c ch\u1ee7 v\u1eadn beta 2 th\u01b0\u1eddng xuy\u00ean ho\u1eb7c thu\u1ed1c ch\u1ed1ng cholinergic cho b\u1ec7nh hen suy\u1ec5n nh\u1eb9 \u0111\u1ebfn trung b\u00ecnh ho\u1eb7c COPD;<\/li>\n<li>Corticosteroid d\u1ea1ng h\u00edt th\u01b0\u1eddng xuy\u00ean cho b\u1ec7nh hen suy\u1ec5n t\u1eeb trung b\u00ecnh \u0111\u1ebfn n\u1eb7ng ho\u1eb7c COPD, trong \u0111\u00f3 d\u1ef1 \u0111o\u00e1n th\u1ec3 t\u00edch th\u1edf ra b\u1eaft bu\u1ed9c trong 1 gi\u00e2y &lt;50%;<\/li>\n<li>Oxy li\u00ean t\u1ee5c t\u1ea1i nh\u00e0 v\u1edbi ch\u1ee9ng suy h\u00f4 h\u1ea5p lo\u1ea1i 1 m\u1ea1n t\u00ednh (pO 2 &lt;8.0kPa, pCO 2 &lt;6.5kPa) ho\u1eb7c suy h\u00f4 h\u1ea5p lo\u1ea1i 2 (pO 2 &lt;8.0kPa, pCO 2 &gt; 6.5kPa).<\/li>\n<\/ul>\n<p>\u0110\u00e3 c\u00f3 m\u1ed9t s\u1ed1 th\u1eed nghi\u1ec7m theo d\u00f5i ri\u00eang v\u00e0 c\u00f3 ki\u1ec3m so\u00e1t ng\u1eabu nhi\u00ean xem x\u00e9t \u0111i\u1ec1u g\u00ec x\u1ea3y ra khi b\u00eanh nh\u00e2n ng\u1eebng thu\u1ed1c: v\u00ed d\u1ee5, \u1ea3nh h\u01b0\u1edfng c\u1ee7a vi\u1ec7c ng\u1eebng s\u1eed d\u1ee5ng thu\u1ed1c benzodiazepin, thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton v\u00e0 thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong ch\u1ee9ng m\u1ea5t tr\u00ed nh\u1edb. C\u0169ng c\u00f3 nh\u1eefng nghi\u00ean c\u1ee9u r\u1ed9ng h\u01a1n v\u1ec1 hi\u1ec7u qu\u1ea3 c\u1ee7a c\u00e1c \u0111\u00e1nh gi\u00e1 thu\u1ed1c; gi\u1ea3m \u0111i g\u00e1nh n\u1eb7ng thu\u1ed1c t\u1ed5ng th\u1ec3 ho\u1eb7c gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng thu\u1ed1c c\u00f3 kh\u1ea3 n\u0103ng kh\u00f4ng ph\u00f9 h\u1ee3p. Nh\u00f3m c\u1ee7a Farrell t\u1ea1i Vi\u1ec7n nghi\u00ean c\u1ee9u Bruy\u00e8re \u0111\u00e3 ph\u00e1t tri\u1ec3n m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p cho ph\u00e9p th\u00f4ng tin n\u00e0y \u0111\u01b0\u1ee3c \u0111\u1ed1i chi\u1ebfu \u0111\u1ec3 gi\u00fap c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh v\u1ec1 th\u1eddi \u0111i\u1ec3m v\u00e0 c\u00e1ch d\u1eebng thu\u1ed1c. Cho \u0111\u1ebfn nay, h\u1ecd \u0111\u00e3 t\u1ea1o ra n\u0103m h\u01b0\u1edbng d\u1eabn c\u1eaft gi\u1ea3m thu\u1ed1c \u2013 \u0111\u1ed1i v\u1edbi c\u00e1c thu\u1ed1c benzodiazepin, thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton, thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n, thu\u1ed1c ch\u1ed1ng t\u0103ng huy\u1ebft \u00e1p, thu\u1ed1c anticholinesterase v\u00e0 memantine, t\u1ea5t c\u1ea3 \u0111\u1ec1u c\u00f3 s\u1eb5n t\u1ea1i depresifyinging.org.<\/p>\n<p>\u201cCh\u00fang t\u00f4i \u0111\u00e3 ph\u00e1t tri\u1ec3n c\u00e1c h\u01b0\u1edbng d\u1eabn c\u1eaft gi\u1ea3m thu\u1ed1c b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng c\u00f9ng m\u1ed9t c\u00e1ch ti\u1ebfp c\u1eadn m\u00e0 m\u1ecdi ng\u01b0\u1eddi s\u1ebd s\u1eed d\u1ee5ng \u0111\u1ec3 ph\u00e1t tri\u1ec3n m\u1ed9t h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb\u201d, theo gi\u1ea3i th\u00edch c\u1ee7a Farrell. Nh\u00f3m c\u0169ng \u0111\u00e3 xu\u1ea5t b\u1ea3n m\u1ed9t t\u00e0i li\u1ec7u h\u01b0\u1edbng d\u1eabn v\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ec3 m\u1ecdi ng\u01b0\u1eddi c\u00f3 th\u1ec3 ph\u00e1t tri\u1ec3n c\u00e1c h\u01b0\u1edbng d\u1eabn ti\u1ebfp theo<\/p>\n<p>\u201cCh\u00fang t\u00f4i bi\u1ebft r\u1eb1ng vi\u1ec7c c\u1eaft gi\u1ea3m thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n\u201d Cheryl Sadowski n\u00f3i, m\u1ed9t nh\u00e0 nghi\u00ean c\u1ee9u thu\u1ed9c Khoa D\u01b0\u1ee3c v\u00e0 Khoa h\u1ecdc D\u01b0\u1ee3c ph\u1ea9m, \u0110\u1ea1i h\u1ecdc Alberta, ng\u01b0\u1eddi \u0111\u00e3 l\u00e0m vi\u1ec7c v\u1edbi Farrell v\u1ec1 c\u00e1c h\u01b0\u1edbng d\u1eabn c\u1eaft gi\u1ea3m s\u1eed d\u1ee5ng benzodiazepine. \u0110i\u1ec1u m\u00e0 ch\u00fang t\u00f4i ch\u1edd \u0111\u1ee3i t\u1eeb nghi\u00ean c\u1ee9u \u1edf Canada v\u00e0 c\u00e1c n\u01a1i kh\u00e1c l\u00e0 [ vi\u1ec7c c\u1eaft gi\u1ea3m \u0111\u01a1n thu\u1ed1c] lu\u00f4n mang l\u1ea1i l\u1ee3i \u00edch th\u1ef1c s\u1ef1 cho b\u1ec7nh nh\u00e2n.<\/p>\n<p>\u0110\u00e3 c\u00f3 m\u1ed9t gi\u1ea3 \u0111\u1ecbnh r\u1eb1ng n\u1ebfu ng\u1eebng s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c c\u00f3 h\u1ea1i, b\u1ec7nh nh\u00e2n s\u1ebd \u00edt g\u1eb7p ph\u1ea3i t\u00e1c h\u1ea1i h\u01a1n. \u201cTuy nhi\u00ean, ch\u00fang t\u00f4i ch\u01b0a ch\u1ee9ng minh \u0111\u01b0\u1ee3c r\u1eb1ng n\u1ebfu ch\u00fang ta d\u1eebng l\u1ea1i, gi\u1ea3 s\u1eed d\u1eebng s\u1eed d\u1ee5ng benzodiazepin, b\u1ea1n s\u1ebd c\u00f3 \u00edt g\u1eb7p t\u00e1c d\u1ee5ng ph\u1ee5 h\u01a1n. Ho\u1eb7c n\u1ebfu ch\u00fang t\u00f4i d\u1eebng sulphonylurea, b\u1ea1n s\u1ebd c\u00f3 \u00edt c\u00e1c \u0111\u1ee3t h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft h\u01a1n\u201d.<\/p>\n<p><strong>M\u1ed9t s\u1ed1 s\u00e1ng ki\u1ebfn \u200b\u200bnghi\u00ean c\u1ee9u \u1edf Canada, \u0111\u01b0\u1ee3c \u0111i\u1ec1u ph\u1ed1i th\u00f4ng qua CaDeN, \u0111ang t\u00ecm c\u00e1ch tr\u1ea3 l\u1eddi nh\u1eefng c\u00e2u h\u1ecfi n\u00e0y.<\/strong><\/p>\n<p>CaDeN \u0111\u00e3 t\u1eadp h\u1ee3p t\u1ea5t c\u1ea3 c\u00e1c h\u01b0\u1edbng d\u1eabn bao g\u1ed3m c\u1ea3 c\u00e1c khuy\u1ebfn ngh\u1ecb v\u1ec1 vi\u1ec7c \u0111i\u1ec1u tr\u1ecb l\u1ea1i. \u0110i\u1ec1u n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ed1i v\u1edbi c\u00e1c h\u01b0\u1edbng d\u1eabn c\u1eaft gi\u1ea3m s\u1eed d\u1ee5ng thu\u1ed1c m\u1ea5t tr\u00ed nh\u1edb \u1edf Canada. V\u00ed d\u1ee5, h\u01b0\u1edbng d\u1eabn th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng \u0111\u1ed1i v\u1edbi suy gi\u1ea3m nh\u1eadn th\u1ee9c khuy\u1ebfn c\u00e1o r\u1eb1ng vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n kh\u00f4ng \u0111i\u1ec3n h\u00ecnh c\u1ee7a b\u1ec7nh nh\u00e2n sa s\u00fat tr\u00ed tu\u1ec7 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 l\u1ea1i \u0111\u1ecbnh k\u1ef3, v\u1edbi n\u1ed7 l\u1ef1c l\u00e0m gi\u1ea3m v\u00e0 ng\u1eebng vi\u1ec7c s\u1eed d\u1ee5ng ch\u00fang. C\u00e1c h\u01b0\u1edbng d\u1eabn c\u0169ng \u0111\u01b0\u1ee3c \u0111\u1eb7t ra khi ng\u1eebng thu\u1ed1c \u1ee9c ch\u1ebf cholinesterase \u2013 v\u00ed d\u1ee5, khi kh\u00f4ng tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb, trong \u0111\u00f3 c\u00f3 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00f4ng th\u1ec3 ch\u1ecbu \u0111\u1ef1ng \u0111\u01b0\u1ee3c li\u00ean quan \u0111\u1ebfn \u0111i\u1ec1u tr\u1ecb ho\u1eb7c khi t\u00ecnh tr\u1ea1ng b\u1ec7nh c\u1ee7a b\u1ec7nh nh\u00e2n l\u00e0m vi\u1ec7c ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng t\u00e1c nh\u00e2n s\u1ebd t\u1ea1o ra c\u00e1c r\u1ee7i ro ho\u1eb7c kh\u00f4ng mang l\u1ea1i hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>\u201cHy v\u1ecdng m\u01b0\u1eddi n\u0103m n\u1eefa, ch\u00fang t\u00f4i kh\u00f4ng c\u00f3 d\u1ef1 \u0111\u1ecbnh s\u1ebd c\u00f3 h\u01b0\u1edbng d\u1eabn c\u1eaft gi\u1ea3m thu\u1ed1c benzodiazepine, ch\u1ec9 hy v\u1ecdng c\u00e1c h\u01b0\u1edbng d\u1eabn v\u1ec1 ch\u1ee9ng m\u1ea5t ng\u1ee7 \u0111\u01b0\u1ee3c vi\u1ebft t\u1ed1t h\u01a1n. \u0110\u00f3 l\u00e0 t\u1ea7m nh\u00ecn c\u1ee7a ch\u00fang t\u00f4i\u201d, Sadowski n\u00f3i.<\/p>\n<p><strong>Trao quy\u1ec1n cho b\u1ec7nh nh\u00e2n<\/strong><\/p>\n<p>CaDeN \u0111\u00e3 \u0111i\u1ec1u ch\u1ec9nh c\u00e1c h\u01b0\u1edbng d\u1eabn c\u1ee7a Bruy\u00e8re v\u00e0 t\u1ea1o ra m\u1ed9t b\u1ed9 t\u00e0i li\u1ec7u c\u00f3 s\u1eb5n mi\u1ec5n ph\u00ed cho nh\u1eefng ng\u01b0\u1eddi k\u00ea \u0111\u01a1n thu\u1ed1c, bao g\u1ed3m c\u00e1c thu\u1eadt to\u00e1n v\u1ec1 c\u1eaft gi\u1ea3m s\u1eed d\u1ee5ng, t\u00e0i li\u1ec7u b\u1ec7nh nh\u00e2n v\u00e0 s\u1ef1 k\u1ebft n\u1ed1i c\u1ee7a d\u01b0\u1ee3c s\u0129-b\u00e1c s\u0129.<\/p>\n<p>T\u00e0i li\u1ec7u b\u1ec7nh nh\u00e2n l\u00e0 ph\u1ea7n t\u00e0i nguy\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i nh\u1ea5t. H\u1ecd \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1eed nghi\u1ec7m trong m\u1ed9t th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean, \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 EMPOWER, v\u1edbi nh\u1eefng ng\u01b0\u1eddi l\u1edbn tu\u1ed5i l\u00e0 nh\u1eefng ng\u01b0\u1eddi s\u1eed d\u1ee5ng thu\u1ed1c benzodiazepin m\u00e3n t\u00ednh.<\/p>\n<p>C\u00e1c t\u00e0i li\u1ec7u n\u00e0y \u0111\u01b0\u1ee3c ph\u00e2n ph\u1ed1i qua th\u01b0 \u0111i\u1ec7n t\u1eed t\u1edbi c\u00e1c nh\u00e0 thu\u1ed1c, \u0111\u1ec1 xu\u1ea5t chi ti\u1ebft t\u1eebng b\u01b0\u1edbc v\u00e0 y\u00eau c\u1ea7u ng\u01b0\u1eddi tham gia th\u1ea3o lu\u1eadn v\u1edbi b\u00e1c s\u0129 ho\u1eb7c d\u01b0\u1ee3c s\u0129 c\u1ee7a h\u1ecd, mang l\u1ea1i t\u1ef7 l\u1ec7 c\u1eaft gi\u1ea3m s\u1eed d\u1ee5ng thu\u1ed1c l\u00e0 27% sau s\u00e1u th\u00e1ng. Cara Tannenbaum, gi\u00e1m \u0111\u1ed1c c\u1ee7a CaDeN cho bi\u1ebft, [k\u1ebft qu\u1ea3 n\u00e0y \u0111\u00e3 \u0111\u1ea1t \u0111\u01b0\u1ee3c] ngay c\u1ea3 v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n 94 tu\u1ed5i \u0111\u00e3 s\u1eed d\u1ee5ng [thu\u1ed1c benzodiazepines] trong 40 n\u0103m. Trong c\u00e1c cu\u1ed9c ph\u1ecfng v\u1ea5n sau \u0111\u00f3, c\u00e1c nh\u00e0 nghi\u00ean c\u1ee9u \u0111\u00e3 ph\u00e1t hi\u1ec7n ra r\u1eb1ng hai ph\u1ea7n ba s\u1ed1 ng\u01b0\u1eddi nh\u1eadn nh\u1eefng t\u00e0i li\u1ec7u n\u00e0y \u0111\u00e3 \u0111\u01b0a n\u00f3 \u0111\u1ebfn ch\u1ed7 b\u00e1c s\u0129 ho\u1eb7c d\u01b0\u1ee3c s\u0129 c\u1ee7a h\u1ecd \u0111\u1ec3 th\u1ea3o lu\u1eadn v\u1ec1 vi\u1ec7c ng\u1eebng thu\u1ed1c an th\u1ea7n \u2013 thu\u1ed1c ng\u1ee7. \u201cNh\u01b0ng trong m\u1ed9t n\u1eeda nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y, b\u00e1c s\u0129 ho\u1eb7c d\u01b0\u1ee3c s\u0129 kh\u00f4ng khuy\u1ebfn kh\u00edch b\u1ec7nh nh\u00e2n t\u1eeb vi\u1ec7c c\u1eaft gi\u1ea3m thu\u1ed1c\u201d, Tannenbaum n\u00f3i.<\/p>\n<p>C\u00f4ng vi\u1ec7c n\u00e0y \u0111\u00e3 d\u1eabn \u0111\u1ebfn th\u1eed nghi\u1ec7m D-Prescribe, nh\u1eb1m t\u00ecm c\u00e1ch h\u01b0\u1edbng d\u1eabn d\u01b0\u1ee3c s\u0129 v\u00e0 b\u00e1c s\u0129 v\u1ec1 nh\u1eefng r\u1ee7i ro ti\u1ec1m \u1ea9n c\u1ee7a m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c \u1edf ng\u01b0\u1eddi gi\u00e0. C\u00e1c nh\u00e0 nghi\u00ean c\u1ee9u \u0111\u00e3 ph\u00e1t tri\u1ec3n m\u1ed9t c\u00f4ng c\u1ee5 m\u00e0 c\u00e1c d\u01b0\u1ee3c s\u0129 s\u1eed d\u1ee5ng \u0111\u1ec3 truy\u1ec1n \u0111\u1ea1t nhu c\u1ea7u c\u1eaft gi\u1ea3m thu\u1ed1c cho c\u00e1c b\u00e1c s\u0129 v\u00e0 g\u1eedi c\u00e1c t\u00e0i li\u1ec7u v\u1ec1 EMPOWER cho b\u1ec7nh nh\u00e2n. T\u1ef7 l\u1ec7 c\u1eaft gi\u1ea3m thu\u1ed1c l\u00e0 g\u1ea7n 43% sau s\u00e1u th\u00e1ng.<\/p>\n<p>Tr\u1ecdng t\u00e2m CaDeN l\u00e0 c\u00e1c c\u00f4ng c\u1ee5 trong c\u1eaft gi\u1ea3m s\u1eed d\u1ee5ng opioid \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111au m\u00e3n t\u00ednh, \u0111au kh\u00f4ng ph\u1ea3i do ung th\u01b0.<\/p>\n<p><em>Ngu\u1ed3n:<a href=\"https:\/\/www.pharmaceutical-journal.com\/news-and-analysis\/features\/deprescribing-the-fightback-against-polypharmacy-has-begun\/20205686.article?firstPass=false\">www.pharmaceutical-journal.com%2Fnews-and-analysis%2Ffeatures%2Fdeprescribing-the-fightback-against-polypharmacy-has-begun%2F20205686.article%3FfirstPass%3Dfalse&amp;anno=2<\/a><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Theo Namudinsider Polypharmacy\u00a0l\u00e0 kh\u00e1i ni\u1ec7m ch\u1ec9 vi\u1ec7c b\u1ec7nh nh\u00e2n ph\u1ea3i s\u1eed d\u1ee5ng nhi\u1ec1u thu\u1ed1c kh\u00e1c nhau \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb cho m\u1ed9t b\u1ec7nh nh\u00e2n. T\u1ef7 l\u1ec7 Polypharmacy \u1edf nh\u1eefng ng\u01b0\u1eddi l\u1edbn tu\u1ed5i \u0111ang \u1edf m\u1ee9c cao nh\u1ea5t t\u1eeb tr\u01b0\u1edbc t\u1edbi nay, khi\u1ebfn ch\u00fang ta c\u1ea7n ph\u1ea3i t\u1eadp trung v\u00e0o vi\u1ec7c gi\u1ea3m b\u1edbt c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00f4ng [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[240],"tags":[],"class_list":["post-11020","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/11020","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/comments?post=11020"}],"version-history":[{"count":1,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/11020\/revisions"}],"predecessor-version":[{"id":11022,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/11020\/revisions\/11022"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=11020"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=11020"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=11020"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}