%0期刊文章%@ 1438- 8871% I JMIR出版物%V 21卡塔尔世界杯8强波胆分析% N 11% P 15385% T使用计算机化决策支持工具减少可能不适当的老年患者处方:系统评价%A蒙泰罗，Luís %A Maricoto,Tiago %A Solha,Isabel %A ribeio -Vaz,Inês %A Martins,Carlos %A Monteiro- soares,Matilde %+ Esgueira+家庭保健单位，阿威罗医疗中心，Rua Pedro Vaz de Eça，阿威罗，葡萄牙，351 00351234312890，luismonteiro.net@gmail.com %K脱处方%K医疗信息应用%K可能不适当的处方%K可能不适当的药物%K计算机化决策支持%D 2019 %7 14.11.2019 %9回顾%J J医学互联网决议%G英文%X背景:老年人更容易受到多重用药和可能不适当的药物处方的影响。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。超过一半(n=10)的研究是随机对照试验，一项是交叉研究，五项是干预前后研究。共有266,562名参与者; 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 %M 31724956 %R 10.2196/15385 %U //www.mybigtv.com/2019/11/e15385 %U https://doi.org/10.2196/15385 %U http://www.ncbi.nlm.nih.gov/pubmed/31724956