东莞市医院老年患者潜在不适当用药的研究  

A study of potentially inappropriate medication use in elderly patients in Dongguan hospitals

作　　者：叶凯宏[1] 王宏刚[1] 江子彪 YE Kai-hong;WANG Hong-gang;JIANG Zi-biao(Dongguan Huangjiang Hospital,Dongguan,Guangdong 523750,China)

机构地区：[1]东莞市黄江医院,广东东莞523750

出　　处：《中国处方药》2022年第6期30-32,共3页Journal of China Prescription Drug

基　　金：东莞市社会科技发展(一般)项目(201950715041057)。

摘　　要：目的 了解医院老年住院患者潜在不合理用药(PIM)现状,分析影响PIM的相关因素。方法 从医院信息系统(HIS)中调取2019年所有65岁以上老年住院患者1 657例,总共医嘱37 894条,其中西药医嘱34 480条,以Excel表格导出患者信息并整理,包括患者住院号、性别、年龄、临床诊断、治疗药物使用情况等,根据《中国老年人潜在不适当用药判断标准(2017年版)》为评价标准,审阅用药医嘱,分析统计患者住院期间PIM情况。结果 纳入的1 657例老年患者中,发生PIM 1 361例,占比82.14%;PIM发生率与性别、年龄、住院天数、用药品种数之间存在显著的关联性(P <0.05);有13例(0.96%)与疾病状态相关的PIM,均患有心力衰竭、骨折或跌倒病史;老年患者使用慎用药物的PIM为1 064例,占比78.18%,循证等级均为中级。结论 老年住院患者PIM发生率较高,性别、年龄、住院天数、用药品种数是PIM的危险因素;慎用药物PIM发生率较高。医院管理部门应采用信息化手段和相关标准,强化事前干预;医生和药师应重视PIM,精简用药数量,密切关注多病、多药患者的个体化给药监护,以确保老年患者用药安全性和合理性。Objective To understand the status of potentially irrational drug use(PIM) in elderly inpatients in hospitals,and to analyze the related factors that affect PIM.Methods A total of 1 657 cases of elderly inpatients over 65 years old in 2019 were retrieved from the Hospital Information System(HIS),with a total of 37 894 medical orders,including 34 480 Western medicine orders.No.,gender,age,clinical diagnosis,use of therapeutic drugs,etc.,according to the evaluation criteria of the "Criteria for Potentially Inappropriate Drug Use in the Elderly in China(2017 Edition)",the medical orders for medication were reviewed,and the PIM status of patients during hospitalization was analyzed and counted.Results Among the 1 657 elderly patients included,1 361 cases of PIM occurred,accounting for 82.14%;there was a significant correlation between the incidence of PIM and gender,age,days of hospitalization,and the number of drug varieties(all P < 0.05);13 cases were(0.96%) PIMs related to disease states were all with a history of heart failure,fractures or falls;1 064 cases of PIM in elderly patients who used cautious drugs accounted for 78.18%,and the evidence-based grades were all intermediate.Conclusion The incidence of PIM in elderly hospitalized patients is higher.Gender,age,length of hospital stay,and number of drugs are the risk factors for PIM.The incidence of PIM is higher in the cautious use of drugs.Hospital management departments should adopt information-based methods and relevant standards to strengthen prior intervention;doctors and pharmacists should pay attention to PIM,reduce the amount of medication,and pay close attention to the individualized medication monitoring of patients with multiple diseases and drugs to ensure the safety of medication for elderly patients and rationality.

关 键 词：老年 患者 不适当药物 健康 

分 类 号：R95[医药卫生—药学]