常用潜在不适当用药筛查标准联合自拟中药判断标准评估分析老年住院患者潜在不适当用药  

Application of Commonly-used PIM Screening Criteria Combined with Self-developed Traditional Chinese Medicine PIM Criteria to Evaluate Potentially Inappropriate Medication in Elderly Inpatients

作　　者：邱奕榕 孙冰婷 顿文亮[1] QIU Yirong;SUN Bingting;DUN Wenliang(Department of Pharmacy,Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing 210001,China;School of Basic Medicine and Clinical Pharmacy,China Pharmaceutical University,Nanjing 210009,China)

机构地区：[1]南京中医药大学附属南京中医院药学部,南京210001 [2]中国药科大学基础医学与临床药学学院,南京210009

出　　处：《医药导报》2024年第1期126-130,共5页Herald of Medicine

摘　　要：目的 探讨医院老年住院患者潜在不适当用药(PIM)情况及影响因素,为临床合理用药提供参考。方法 纳入南京市中医院2021年10—12月116例老年住院患者病历,分别依照Beers标准(2019年版)、《中国老年人潜在不适当用药判断标准(2017年版)》和自拟中药PIM标准进行评价,并进行影响因素分析。结果 依据Beers标准共筛查14例次PIM,主要为苯二氮芯卓类药物;依据2017年版中国PIM标准共筛查49例次PIM,主要为氯吡格雷和神经系统药物;依据自拟中药PIM标准共筛查PIM 42例次,其中毒性中药、含毒性中药制剂相关PIM占40.5%。影响因素分析结果表明,科室和用药数量与PIM发生具有相关性(P<0.05)。结论 老年住院患者PIM发生率高,且老年患者广泛使用中药、中成药,探索性构建中药PIM标准并对老年住院患者医嘱进行PIM筛查,是保障老年患者用药安全的需要。Objective To investigate potentially inappropriate medication(PIM)and influencing factors of elderly hospitalized patients,and to provide a reference for clinically rational drug use.Methods A total of 116 medical records of elderly hospitalized patients from October to December 2021 were collected.The Beers criteria(2019),Chinese PIM criteria(2017),and self-developed traditional Chinese medicine PIM criteria were applied respectively to analyze the potentially inappropriate medication situation.Analysis of influencing factors of PIM was also conducted.Results According to the Beers criteria(2019),42 items of PIM were discovered,and the drugs with high frequency were benzodiazepines.According to Chinese PIM criteria(2017),there were 49 items of PIM,mainly involving clopidogrel and nervous system drugs.According to self-developed traditional Chinese medicine PIM criteria,42 cases of PIM were screened,of which toxic conventional Chinese medicine and preparations containing harmful traditional Chinese medicine accounted for 40.5%.Influencing factors analysis showed the common influencing factors of PIM are department and the number of treatments used(P<0.05).Conclusions Elderly inpatients have a high incidence of PIM.Due to the extensive use of traditional Chinese medicine and Chinese patent medicines by elderly patients,the exploratory construction of PIM standards for traditional Chinese medicine and screening for elderly inpatients'medical orders are necessary to ensure drug safety in elderly patients.

关 键 词：潜在不适当用药 多重用药 中药 老年住院患者 

分 类 号：R969.3[医药卫生—药理学]