北京清华长庚医院门诊老年患者多重用药调查及潜在不适当用药分析  

The investigation of multiple drug use and potential inappropriate medication use analysis in elderly outpatients in Beijing Tsinghua Changgung Hospital

作　　者：谢吉科 颜妍 陈朋[2] 胡永芳 XIE Ji-ke;YAN Yan;CHEN Peng;HU Yong-fang(Department of Clinical Pharmacy,Beijing Tsinghua Changgung Hospital Affiliated to Tsinghaa University,School of Clinical Medicine,Tsinghua University,Beijing 102218,China;Department of Business Management,Beijing Tsinghua Changgung Hospital Affiliated to Tsinghaa University,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院清华大学临床医学院临床药学科,北京102218 [2]清华大学附属北京清华长庚医院清华大学临床医学院经营管理组,北京102218

出　　处：《临床药物治疗杂志》2018年第11期52-55,60,共5页Clinical Medication Journal

摘　　要：目的:通过对北京清华长庚医院2016年和2017年每年1月和8月门诊老年患者用药的回顾性调查,发现潜在不适当用药(potential mappropriate medication,PIM),为药物治疗管理的开展提供依据,促进老年患者合理用药。方法:依据美国老年患者不适当用药Beers标准(2015版),对门诊≥60岁患者处方进行统计分析,评价存在PIM的情况。结果:2016年≥60岁老人就诊比例为33.13%,人均药费(408.99±14.22)元,人均使用药物(2.72±0.02)种,使用≥5种药物比例为14.50%; 2017年≥60岁老人就诊比例为32.60%,人均药费(460.47±6.30)元,人均使用药物(3.00±0. 02)种,使用≥5种药物比例为19.08%。2016年老年人PIM比例为14. 97%, 2017年比例为15.55%;由于药物与疾病或药物与症状相互作用,可能加重疾病或症状的老年PIM 2016年比例为0.29%,2017年比例为1.83%;老年人应谨慎使用的药物2016年比例为4.27%,2017年比例为6.10%;老年人应避免的非抗感染药物间相互作用2016年发生1人次,2017年发生7人次。结论:潜在不适当用药比例2017年较2016年有所上升。Objective:Through retrospective investigation and evaluation of elderly outpatients in Beijing Tsinghua Changgung Hospital from January and August 2016,2017,this study was designed to find our potential inappropriate medication use (PIM),and provide the basis for the development of medication therapy management (MTM),promote the rational use of drugs in elderly patients. Methods:Based on American Geriatrics Society Beers Criteria (2015 edition),prescriptions of January and August of 2016 and 2017 were evaluated for the existence of PIMs. Results:In 2016,the percentage of outpatients aged at 60 or over 60 years old in our hospital was 33.13%,per capita expenses of medicine were (408.99±14.22)yuan RMB,per capita kinds of using drugs were 2.72±0.02,and the percentage of polypharmacy was 14.50%. In 2017,the rate of see the doctor is 32.60% of 60 or over 60 years old outpatients,per capita expenses of medicine are (460.47±6.30) yuan RMB,per capita kinds of using drugs were 3.00±0.02,the percentage of polypharmacy were 19.08%. The rates of potential inappropriate medication use were 14.97% in 2016,and 15.55% in 2017. The rates of potential inappropriate medication use due to drug-disease or drug-syndrome interactions that may exacerbate the disease or syndrome were 0.29% in 2016 and 1.83% in 2017. The rates of potential inappropriate medication to be used with caution in old adults were 4.27% in 2016,and 6.10% in 2017. The numbers of potential clinically important non-anti-infective drug-drug interactions that should be avoided in older adults were 1 in 2016 and 7 in 2017.Conclusion: In 2017,the proportion of PIMs increased compared with 2016.

关 键 词：Beers标准 老年患者 多重用药 潜在不适当用药 

分 类 号：R925[医药卫生—药学]