老年病科门诊患者潜在不适当用药调查及风险因素分析  

Investigation on potentially inappropriate medication in elderly outpatients of the Geriatrics Department and analysis of risk factors

作　　者：吴玉婷[1] 李智勤[1] WU Yuting;LI Zhiqin(Department of Pharmacy,Taizhou People’s Hospital,Jiangsu Taizhou 225300,China)

机构地区：[1]泰州市人民医院药学部,江苏泰州225300

出　　处：《药学服务与研究》2020年第2期122-126,131,共6页Pharmaceutical Care and Research

摘　　要：目的:调查泰州市人民医院老年病科门诊患者潜在不适当用药(potentially inappropriate medication,PIM)情况,并分析PIM相关风险因素。方法:采用随机数字表法抽取2018年1-10月就诊于本院老年病科的门诊患者(≥60周岁)作为研究对象,通过自拟调查问卷收集病例资料。采用《中国老年人潜在不适当用药判断标准(2017年版)》评价患者PIM发生情况,用Logistic回归分析确定PIM相关风险因素。结果:共有960例患者完成调查,平均年龄(71.32±7.99)岁,平均患有(2.87±1.26)种疾病,平均使用(3.97±1.16)种药物。251例患者(26.15%)存在≥1个用药风险点。425例次应用标准内的目录药物。PIM例次最高药物包括苯二氮 GFDA1 类药物(艾司唑仑和地西泮)、血液系统用药(氯吡格雷)和内分泌系统用药(胰岛素)。53例次存在与疾病状态相关的PIM。Logistic回归分析结果表明,用药种数,患有冠心病、高血压、糖尿病、疼痛及失眠是老年患者发生PIM的独立风险因素。结论:本院老年病科门诊患者的PIM现状仍有待改进,用药种数及相关慢性病是主要风险因素,药师及临床医师应予以重视。Objective:To investigate potentially inappropriate medication(PIM)in elderly outpatients of the Geriatrics Department in the Taizhou People’s Hospital,and to analyze related risk factors of PIM.Methods:The outpatients over 60 years old who sought medical care in the Geriatrics Department of the Taizhou People’s Hospital from January 2018 to October 2018 were enrolled as study subjects by using random cluster method,and clinical data of the subjects were collected through a self-designed questionnaire form.The PIM incidence was evaluated by The criteria of potentially inappropriate medication for elderly patients in China(2017 edition),and the PIM-related risk factors were analyzed by using Logistic regression.Results:The average age of the total 960 patients who completed the survey was(71.32±7.99)years and they averagely had(2.87±1.26)diseases and used(3.97±1.16)kinds of drugs.Of the total subjects surveyed,251(26.15%)had at least one PIM risk factor.425 case times used the drugs listed in the evaluation standands.The top or most frequently used drugs in the treatment with the highest PIM were:benzodiazepines(estazolam,diazepam),drugs for blood system diseases(clopidogrel)and endocrine system drugs(insulin).There were 53 cases of PIM related to disease status.The results of Logistic regression analysis showed that the number of drugs used,coronary heart disease,hypertension,diabetes,pain and insomnia were independent risk factors of PIM in elderly patients.Conclusion:The PIM status for the outpatients of the Geriatrics Department in this hospital remains to be improved.The number of drugs and related chronic diseases are the main risk factors of PIM,to which clinical pharmacists and physicians should pay more emphasis.

关 键 词：老年人 潜在不适当用药 风险因素 

分 类 号：R969.3[医药卫生—药理学]