老年住院慢病患者多重用药发生率及其影响因素研究  

Incidence and Influencing Factors of Polypharmacy Among Elderly Inpatients with Chronic Diseases

作　　者：唐静[1] 王可[1] 杨昆 姜德春[1] 方向华 苏甦[1] 丁倩 林阳[3] 陈世才[4] 顾红燕 李朋梅[6] 闫素英[1] TANG Jing;WANG Ke;YANG Kun;JIANG Dechun;FANG Xianghua;SU Su;DING Qian;LIN Yang;CHEN Shicai;GU Hongyan;LI Pengmei;YAN Suying(Department of Pharmacy,Xuanwu Hospital,Capital Medical University,Beijing,China 100053;Evidence-Based Medicine,Xuanwu Hospital,Capital Medical University,Beijing,China 100053;Department of Pharmacy,Beijing Anzhen Hospital Affiliated to Capital Medical University,Beijing,China 100029;Department of Pharmacy,Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing,China 101149;Department of Pharmacy,Beijing Shijitan Hospital Affiliated to Capital Medical University,Beijing,China 100038;Department of Pharmacy,China-Japan Friendship Hospital,Beijing,China 100029)

机构地区：[1]首都医科大学宣武医院药学部,北京100053 [2]首都医科大学宣武医院循证医学中心,北京100053 [3]首都医科大学附属北京安贞医院药学部,北京100029 [4]首都医科大学附属北京潞河医院药学部,北京101149 [5]首都医科大学附属北京世纪坛医院药学部,北京100038 [6]中日友好医院药学部,北京100029

出　　处：《中国药业》2022年第16期119-122,共4页China Pharmaceuticals

基　　金：北京市科技计划课题[D181100000218002]。

摘　　要：目的探讨北京市老年住院慢性疾病(简称慢病)患者多重用药的发生情况及其影响因素。方法抽取北京市5家三级甲等医院4个科室(神经内科、老年科、心内科、内分泌科)中年龄不小于65岁,至少患高血压、高脂血症、冠状动脉粥样硬化性心脏病(简称冠心病)、脑梗死、2型糖尿病中的1种,并于2017年3月、6月、9月、12月首周出院患者的临床基本信息。统计住院期间使用5种及以上药物患者的临床基本信息,计算多重用药发生率,并分析其影响因素。结果共纳入912例患者,其中男455例,女457例;中位年龄74岁;中位用药品种数为9种。多重用药发生率为93.42%。单因素分析结果表明,年龄、出院诊断疾病数、查尔森合并症指数(CCI)评分、高血压、2型糖尿病、冠心病、高脂血症是多重用药的影响因素;多因素Logistic回归分析结果表明,出院诊断疾病数、2型糖尿病、冠心病是多重用药的独立影响因素。结论多病共存、患有2型糖尿病或冠心病的老年慢病住院患者更易发生多重用药,临床应重点关注相关人群,减少过度治疗,提高用药的合理性。Objective To investigate the incidence of polypharmacy in elderly inpatients with chronic diseases in Beijing and its influencing factors.Methods The clinical basic information of inpatients≥65 years old who had at least one chronic disease(hypertension,hyperlipidemia,coronary heart disease,cerebral infarction or type 2 diabetes mellitus)in four departments(Department of Neurology,Department of Geriatrics,Department of Cardiology and Department of Endocrinology)of five class Ⅲ grade A hospitals in Beijing and who were discharged in the first week of March,June,September and December 2017 were selected.The clinical basic information of inpatients who used five or more drugs during hospitalization was counted,the incidence of polypharmacy was calculated,and its influencing factors were analyzed.Results A total of 912 inpatients were included,including 455 males and 457 females.The median age of inpatients was 74 years old,and the median number of drug varieties was 9.The incidence of polypharmacy was 93.42%.Univariate analysis showed that age,number of diseases diagnosed at discharge,Charlson complication index(CCI)score,hypertension,type 2 diabetes mellitus,coronary heart disease and hyperlipidemia were the influencing factors of polypharmacy.Logistic regression analysis showed that the number of diseases diagnosed at discharge,type 2 diabetes mellitus and coronary heart disease were independent influencing factors of polypharmacy.Conclusion Polypharmacy is more likely to occur in elderly inpatients with chronic diseases such as multiple diseases,type 2 diabetes mellitus or coronary heart disease.We should pay attention to the relevant population,reduce over-treatment,and improve the rationality of drugs use.

关 键 词：多重用药 影响因素 老年患者:住院患者 慢性疾病 用药安全 

分 类 号：R969.3[医药卫生—药理学]