老年住院患者潜在不适当用药情况及影响因素  

Prevalence and Risk Factors of Potentially Inappropriate Medication in Elderly Inpatients

作　　者：闫瑶[1] 吕顺忠[1] 王志[1] 潘慧敏 杨建华[1] YAN Yao;LYU Shunzhong;WANG Zhi;PAN Huimin;YANG Jianhua(Department of Pharmacy,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院药学部,乌鲁木齐830011

出　　处：《医药导报》2021年第3期320-324,共5页Herald of Medicine

摘　　要：目的使用2019版Beers标准对新疆医科大学第一附属医院老年住院患者潜在不适当用药(PIM)发生率进行评价,确定PIM发生相关危险因素,为促进老年患者的合理用药提供参考。方法采用回顾性研究方法,收集该院2019年9-12月老年病科、高血压科、冠心病科年龄≥65岁出院患者病历资料,使用2019版Beers标准评价PIM发生情况,使用Logistic回归分析确定PIM发生相关危险因素。结果纳入病例344例,其中女178例(占51.74%),男166例(占48.26%),年龄65~92岁[平均(72.85±5.93)岁],住院时间3~23 d [平均(7.05±2.85) d],疾病诊断种类数1~26种[平均(8.52±4.36)种],住院期间用药种类数1~39种[平均(8.71±4.60)种]。其中124例(36.05%)发生最少1种PIM,发生PIM较多的是非甾体抗炎药、苯二氮类药物以及保钾利尿药联合肾素-血管紧张素系统抑制剂。Logistic回归分析结果显示,高血压科、疾病诊断种类6~10种、用药种类6~10种患者更易于发生PIM。结论老年住院患者PIM发生率较高,临床药师需更加关注患有6种以上疾病或使用6种以上药物的老年患者,优化患者用药,减少PIM发生,促进老年患者合理用药。Objective To evaluate the prevalence of potentially inappropriate medication(PIM)in elderly inpatients who had been lived in the First Affiliated Hospital of Xinjiang Medical University using Beers criteria(2019 edition),and to determine the risk factors related to the prescription of PIM,so as to provide reference for the rational use of drugs in elderly patients.Methods In the retrospective study,the patients aged≥65 years at department of geriatrics,hypertension,or coronary heart disease from September to December,2019 were included.TheBeers criteria of 2019 edition was used to identify PIM.A logistic regression analysis was used to identify the risk factors of PIM.Results Totally,344 inpatients were enrolled,included,178 females and 166 males.The inpatients were 65-92(72.85±5.93)years old,the hospital stay length was 3-23(7.05±2.85)d,the number of diagnoses was 1-26(8.52±4.36),and the kinds of drug used was 1-39(8.71±4.60).124(36.05%)inpatients had at least one PIM,and the most prevalent PIM occurred in non-steroidal anti-inflammatory drugs,benzodiazepines and combination of potassium-sparing diuretics and RAS inhibitors.Logistic regression analysis showed that PIM was more likely to occur in patients of hypertension department,with 6-10 kinds of diseases,or whose treatment regimen contained 6-10 kinds of drugs.Conclusion The prevalence of PIM in elderly inpatients is high in elderly patients with more than 6 diseases or using more than 6 drugs.Clinical pharmacists should pay more attention to them in order to optimize medication regimens,reduce the PIM,and promote rational drug use in elderly patients.

关 键 词：Beers标准 老年人 住院患者 潜在不适当用药 

分 类 号：R969.3[医药卫生—药理学] R95[医药卫生—药学]