老年住院患者潜在不适当用药及影响因素分析  

Analysis of potentially inappropriate medication and risk factors in older inpatients

作　　者：顾平[1] 李钟勇[1] 米佳丽[1] 陈平 GU Ping;LI Zhongyong;MI Jiali;CHEN Ping(Department of Pharmacy,Suining Central Hospital of Sichuan Province,Sichuan Suining 629000,China)

机构地区：[1]四川省遂宁市中心医院药学部

出　　处：《药学服务与研究》2019年第5期345-348,400,共5页Pharmaceutical Care and Research

摘　　要：目的:分析四川省遂宁市中心医院老年住院患者的潜在不适当用药(potentially inappropriate medication,PIM)及影响因素,为促进合理用药提供依据。方法:以《中国老年人潜在不适当用药判断标准》为依据,对本院2017年7-12月老年病区住院患者的PIM进行统计,并采用单因素χ^2检验和二元logistic回归确定其影响因素。结果:共纳入1196例老年住院患者,758例(63.38%)具有PIM,其中与药物相关PIM726例(60.70%),与疾病相关PIM110例(9.20%)。单因素χ^2检验结果显示:罹患疾病数、联合用药数、住院天数、失眠、高血压、凝血功能障碍或接受抗凝治疗、慢性阻塞性肺疾病、糖尿病及疼痛与PIM具有相关性,且差异具有统计学意义(P<0.05)。二元logistic回归分析显示:罹患疾病数(≥10种疾病)、联合用药数(10~19种药品)、联合用药数(≥20种药品)、失眠、高血压、慢性阻塞性肺疾病、骨质疏松、糖尿病及疼痛是PIM的影响因素,差异具有统计学意义(P<0.05)。结论:本院老年住院患者存在较多的PIM,是罹患疾病数、联合用药数、失眠、高血压、糖尿病和疼痛等多种因素相互影响的结果。Objective:To analyze potentially inappropriate medication (PIM) and risk factors in older inpatients in Suining Central Hospital of Sichuan Province,so as to provide evidence for rational application of drugs.Methods:Based on the Criteria of potentially inappropriate medication in older patients in China,a statistical analysis was made on the older inpatients hospitalized in the gerontic ward of the hospital from July to December 2017.Single factor chi-square test and multiple logistic regression were used to identify risk factors.Results:Totally included in the study were 1196 older inpatients,of whom 758 were involved in PIM,accounting for 63.38%,and 726 inpatients were of drug-related PIM,accounting for 60.70%,and 110 inpatients were of disease-related PIM,accounting for 9.20%. Single factor chi-square test showed that there was close association between PIM and the number of diseases,the number of combined medication,the hospitalization days,insomnia,hypertension,blood coagulation disorder or anticoagulant therapy,chronic obstructive pulmonary disease (COPD),diabetes and pain,with statistically significant difference( P <0.05).Multiple logistic regression analysis showed that the number of diseases (≥10 diseases),the number of combined medication (10-19 drugs),the number of combined medication (≥20 drugs),insomnia,hypertension,COPD,osteoporosis,diabetes and pain were influential factors of PIM,also with statistically significant difference ( P <0.05). Conclusion:There are more PIM in older inpatients in the hospital,which is the result of the interaction of various influential factors,such as the number of diseases,the number of combined medication,insomnia,hypertension,diabetes and pain.

关 键 词：潜在不适当用药 《中国老年人潜在不适当用药判断标准》 影响因素 合理用药 

分 类 号：R969.3[医药卫生—药理学]