@文章{info:doi/10.2196/15385，作者="Monteiro, Lu{\'i}s and Maricoto, Tiago and Solha, Isabel and Ribeiro-Vaz, In{\^e}s and Martins, Carlos and Monteiro- soares, Matilde"，标题="使用计算机化决策支持工具减少老年患者可能不适当的处方:系统评价"，期刊="J Med Internet Res"，年="2019"，月="11"，日="14"，量="21"，数="11"，页数="e15385"，关键词="去处方;医学信息学应用;可能不恰当的处方;可能不恰当的用药;背景:老年人更容易受到多重配药和潜在不适当药物处方的影响。有几种方法来解决多重用药以防止其发生。我们主要关注计算机化决策支持工具。目的:回顾现有文献，以了解计算机化决策支持工具是否减少了老年患者可能不适当的处方或可能不适当的药物，并影响健康结果。方法:我们通过检索MEDLINE、CENTRAL、EMBASE和Web of Science数据库中截至2018年2月发表的介入性研究文献进行了系统综述，以评估计算机化决策支持工具对65岁及以上人群潜在不适当药物和潜在不适当处方的影响。结果:共鉴定文献3756篇，纳入文献16篇。 More than half (n=10) of the studies were randomized controlled trials, one was a crossover study, and five were pre-post intervention studies. A total of 266,562 participants were included; of those, 233,144 participants were included and assessed in randomized controlled trials. Intervention designs had several different features. Computerized decision support tools consistently reduced the number of potentially inappropriate prescriptions started and mean number of potentially inappropriate prescriptions per patient. Computerized decision support tools also increased potentially inappropriate prescriptions discontinuation and drug appropriateness. However, in several studies, statistical significance was not achieved. A meta-analysis was not possible due to the significant heterogeneity among the systems used and the definitions of outcomes. Conclusions: Computerized decision support tools may reduce potentially inappropriate prescriptions and potentially inappropriate medications. More randomized controlled trials assessing the impact of computerized decision support tools that could be used both in primary and secondary health care are needed to evaluate the use of medication targets defined by the Beers or STOPP (Screening Tool of Older People's Prescriptions) criteria, adverse drug reactions, quality of life measurements, patient satisfaction, and professional satisfaction with a reasonable follow-up, which could clarify the clinical usefulness of these tools. Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO) CRD42017067021; https://www.crd.york.ac.uk/prospero/display{\_}record.php?ID=CRD42017067021 ", issn="1438-8871", doi="10.2196/15385", url="//www.mybigtv.com/2019/11/e15385", url="https://doi.org/10.2196/15385", url="http://www.ncbi.nlm.nih.gov/pubmed/31724956" }