Abstract:

Objective To construct a program for elderly patients with polypharmacy after percutaneous coronary intervention，and to ensure the safety of patients’ polypharmacy throughout the process. Methods Based on evidence-based methods to retrieve domestic and foreign literature，and guided by the 4R crisis management theory，the first draft of the medication management program was formulated by the research group，and the final program was revised and established according to the experts’ opinions by Delphi method from January to July 2022. Results 15 experts participated in 2 rounds of consultations，and the effective recovery rate of questionnaire was 100%. The expert authority scores of 2 rounds were 0.90，and the importance and operability of the second round of expert opinions Kendall harmony were 0.216 and 0.289. The final program contained 4 primary indicators，7 secondary indicators and 23 tertiary indicators. Conclusion The constructed medication management program for elderly patients with polypharmacy after percutaneous coronary intervention is scientific and comprehensive，which can provide a theoretical basis and practical direction for the management of patients.

Key words: Aged, Percutaneous Coronary Intervention, Polypharmacy, Medication Therapy Management, 4R-Model Crisis Management Theory, Delphi Technique, Nursing Care

摘要：

目的 构建经皮冠状动脉介入治疗术后老年患者多重用药管理方案，以保证患者用药安全。 方法 2022年1月—7月，基于循证方法，系统检索国内外文献，以4R危机管理理论为指导，经研究小组讨论，制订经皮冠状动脉介入治疗术后老年患者多重用药管理方案初稿，并通过德尔菲专家函询形成方案终稿。 结果 共15名专家完成2轮函询，问卷有效回收率均为100%；专家权威系数为0.90；第2轮专家意见重要性及可行性肯德尔和谐系数分别为0.216、0.289。最终形成的经皮冠状动脉介入治疗术后老年患者多重用药管理方案包括风险缩减、风险预备、危机应对和监控反馈4项一级指标、7项二级指标、23项三级指标。 结论 该研究构建的经皮冠状动脉介入治疗术后老年患者多重用药管理方案科学全面，可为患者的多重用药管理提供理论依据和实践方向。

关键词: 老年人, 经皮冠状动脉介入治疗, 多重用药, 用药管理, 危机管理理论, 德尔菲技术, 护理