基于Beers标准和全医嘱审核的多院区老年住院患者合理用药调研  

Investigation of rational drug use in elderly inpatients in multi-hospital campus based on Beers criteria and full medication order review

作　　者：朱玲玲[1] 周权[2] ZHU Lingling;ZHOU Quan(Department of Cadre Health Care,the Second Affiliated Hospital Zhejiang University School of Medicine,Zhejiang Province,Hangzhou310009,China;Department of Pharmacy,the Second Affiliated Hospital Zhejiang University School of Medicine,Zhejiang Province,Hangzhou310009,China)

机构地区：[1]浙江大学医学院附属第二医院干部保健科,浙江杭州310009 [2]浙江大学医学院附属第二医院药学部,浙江杭州310009

出　　处：《中国当代医药》2024年第4期32-35,41,共5页China Modern Medicine

基　　金：浙江省教育厅科研项目(Y202249568)。

摘　　要：目的基于Beers标准和全医嘱审核机制,了解效率医疗背景下多院区≥65岁老年住院患者潜在不适当用药(PIM)情况。方法对2023年6月15日浙江大学医学院附属第二医院解放路院区和博奥院区≥65岁老年患者的医嘱进行全处方点评。记录PIM医嘱以及存在用药风险、需要加强药物治疗监测的医嘱。观察PIM类型、内科系统的PIM发生率、外科系统的PIM发生率以及两个不同院区的PIM发生率。结果共调查2050例住院患者的住院医嘱,≥65岁的老年患者共888例(43.32%),其中存在PIM的患者213例(23.99%)。解放路院区和博奥院区PIM发生率比较,差异无统计学意义(P>0.05)。内科系统和外科系统的PIM发生率比较,差异无统计学意义(P>0.05)。≥65岁的老年患者的PIM类型包括不良反应预防措施不足、疾病状态下选药不适宜、同类药品选择不适宜、用法用量不适宜、存在药物相互作用风险。结论关注老年住院患者合理用药,不仅可以提高疗效,缩短平均住院日,对于降低整体治疗费用和不良事件发生也有益。通过调研,医院可明确基线水平,拟着手进行集束缚化管理的对症干预。Objective To investigate the potential inappropriate medication(PIM)in elderly inpatients≥65 years old in a multi-hospital campus based on Beers criteria and full medication order review.Methods The full prescription reviews were conducted for the elderly patients≥65 years old in Jiefang Road Campus and Bo'ao Campus of the Second Affiliated Hospital Zhejiang University School of Medicine on June 15,2023.PIM medical orders and those with medication risks that require strengthened drug treatment monitoring were recorded.The types of PIM,the incidence of PIM in the medical system,the incidence of PIM in the surgical system,and the incidence of PIM in two different hospitals were observed.Results A total of 2050 hospitalized patients were investigated,including 888 elderly patients(43.32%),and there were 213 patients with PIM(23.98%).There was no significant difference in the incidence of PIM between Jiefang Road Campus and Bo'ao Campus(P>0.05).In addition,there was no significant difference in the incidence of PIM between medical system and surgical system(P>0.05).The types of PIM in elderly patients≥65 years old included insufficient preventive measures for adverse reactions,inappropriate drug selection in the disease state,inappropriate drug selection in the same class,inappropriate usage and dosage,and the risk of drug interaction.Conclusion Paying attention to rational drug use in elderly inpatients can not only improve the efficacy and shorten the average length of stay,but also reduce the overall treatment cost and the occurrence of adverse events.Through the investigation,the hospital can clarify the baseline level and plan to carry out the symptomatic intervention of the centralized management.

关 键 词：老年患者 合理用药 潜在不恰当用药 Beers标准 医嘱审核 

分 类 号：R969.3[医药卫生—药理学]