精神科病院における総合感冒薬による転倒事故の防止対策

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The frequency of accidental falls in psychiatric patients is reported to be markedly higher (46.5%) than in patients in other medical departments (15.7%). In order to prevent accidental falls, we provided physicians and nurses with pharmaceutical information on the adverse effects of cold medicines and traditional Chinese medicines. We also investigated the annual number of falls among inpatients before and after beginning our pharmaceutical information service. To do this, a questionnaire concerning cold medicines and traditional Chinese medicines was sent to physicians and nurses 2 years after starting the service. Owing to the provision of information, there were reductions in the annual number of falls (212 to 143), number of falls in patients taking cold medicines (8 to 1), percentage of falls in patients taking cold medicines among all falls (3.8% to 0.7%), and frequency of prescribing cold medicines for the common cold (96% to 75%). The questionnaire results also showed that 68% of physicians and nurses observed dizziness as an adverse effect of cold medicines, and 71% of physicians exercised caution with respect to the risk of falls due to cold medicines. To analyze the causes of accidental falls, a self-organizing map (SOM) was applied to the clinical data. The results suggested that the administration of cold medicines together with comparatively low dosages of chlorpromazine, or an equivalent antipsychotic, and two or more kinds of medication for Parkinson's disease was likely to lead to accidental falls. Thus, for patients having a high risk of falls, the co-administration of cold medicines and psychotropic drugs may further increase such risk.
2009-01-10

精神科病院における総合感冒薬による転倒事故の防止対策

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