双标准分析神经内科老年患者潜在不适当用药及影响因素  

Inappropriate medication and its influencing factors in elderly inpatients of neurological department analyzed by double criteria

作　　者：李代毅 王娜[1] 黄勇[2] 李蕾[1] 钱妍[1] LI Daiyi;WANG Na;HUANG Yong;LI Lei;QIAN Yan(Department of Pharmacy,Second Affiliated Hospital of Chongqing Medical University,Chongqing 400042,China;Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第二医院药学部,400042 [2]重庆医科大学,400016

出　　处：《重庆医学》2022年第23期4032-4038,4042,共8页Chongqing medicine

基　　金：重庆市科卫联合医学科研面上项目(2020MSXM056);重庆市教委医学科研项目(KJQN201800413)。

摘　　要：目的以Beers标准(2019)、中国标准(2017)回顾性分析神经内科老年住院患者潜在不适当用药(PIM),分析其影响因素并探讨两种评价标准的适用性,为推进老年患者合理用药提供参考依据。方法选取2020年1-6月重庆医科大学附属第二医院收治的年龄大于或等于65岁的住院患者861例,收集患者年龄、性别、处方等信息。采用Beers标准、中国标准审查PIM,并应用二元logistic回归模型筛选变量,确定PIM发生的相关危险因素。结果861例患者中按照Beers标准和中国标准发现至少1项PIM者分别为503例(58.42%)、492例(57.14%);依照Beers标准评估,用药种类、住院时间为PIM发生的相关危险因素;依照中国标准评估,住院时间、疾病数量、用药种类为PIM发生的相关危险因素。结论用药种类大于或等于5种时应评估老年人处方的合理性,联合应用两种标准能审查出更多PIM者,Beers标准在神经内科更适用。Objective To use the Beers criteria(2019)and China criteria(2017)to retrospectively analyze the potential inappropriate medication(PIM)in elderly inpatients of the neurology department,to analyze its influencing factors and explore the applicability of the two evaluation criteria so as to provide a reference for promoting the rational drug use for elderly patients.Methods A total of 861 inpatients aged≥65 years old treated in the Second Affiliated Hospital of Chongqing Medical University from January to June 2020 were selected.The informations such as the age,gender and prescription were collected.The Beers criteria and China criteria were used to investigate PIM and binary Logistic regression model was used to screen variables to determine the relevant risk factors for PIM occurrence.Results Among 861 patients,according to the Beers criteria and China criteria,at least 1 item of PIM was found in 503 cases(58.40%)and 492 cases(57.14%)respectively.In the evaluation according to the Beers criteria,the medication type and hospitalization time were the related risk factors for PIM occurrence;in the evaluation according to China criteria,the diseases number,hospitalization time and medication type were the relevant risk factor for PIM occurrence.Conclusion The rationality of prescription in the elderly should be evaluated when the medication kinds is≥5.The combined application of the two criteria can identify more PIM,and the Beers criteria are more suitable in the neurology department.

关 键 词：中国标准 Beers标准 潜在不适当用药 老年住院患者 

分 类 号：R969.3[医药卫生—药理学]