基于潜在不适当用药标准分析心内科老年患者出院带药处方情况及其影响因素  

Analysis of elderly cardiology patients based on criteria for potentially inappropriate medication use discharge with medication prescription and its influencing factors

作　　者：李娜[1] 陈慧[1] 张馨[1] 王维忠[1] 庄永如 宋金方 LI Na;CHEN Hui;ZHANG Xin;WANG Weizhong;ZHUANG Yongru;SONG Jinfang(Department of Pharmacy,Taizhou People’s Hospital,Taizhou 225300,China;School of Pharmacy,Xuzhou Medical University,Xuzhou 221000,China;Department of Pharmacy,Affiliated Hospital of Jiangnan University,Wuxi 214000,China)

机构地区：[1]泰州市人民医院药学部,江苏泰州225300 [2]徐州医科大学药学院,江苏徐州221000 [3]江南大学附属医院药学部,江苏无锡214000

出　　处：《现代药物与临床》2024年第3期753-759,共7页Drugs & Clinic

基　　金：江苏省药学会–恒瑞医院药学基金(H202025)。

摘　　要：目的探讨心血管内科老年患者出院带药处方的情况,并对其影响因素进行分析,以提高老年患者合理用药的水平。方法回顾性分析2023年1~12月从泰州市人民医院心血管内科出院的老年患者,根据2023年版Beers标准及《中国老年人潜在不适当用药判断标准(2017年版)》,应用多因素Logistic回归分析,对影响潜在不适当用药(PIM)的因素进行分析。通过对患者所在病房是否有临床药师参与进行分组,比较PIM的发生率。结果纳入老年患者共1982例,Beers标准筛选出PIM病例1518例(76.59%),《中国老年人潜在不适当用药判断标准》筛选出PIM病例1276例(64.38%);多因素Logistic回归分析结果表明,按照2023年版Beers标准和《中国老年人潜在不适当用药判断标准(2017年版)》,疾病种数、患者用药的种类均是影响PIM发生的因素(P<0.05)。临床药师干预后,PIM发生率降低(P<0.05)。结论疾病种数、用药种类是影响PIM发生的因素,临床医师及药师应该尤为重视多重慢病患者,降低老年人多重用药的危险。临床药师对老年患者的出院带药进行用药管理,有利于降低PIM的发生率,促进临床合理用药。Objective To explore the situation of elderly patients discharged from cardiovascular medicine department with medication prescriptions and to analyze the influencing factors in order to improve the rational use of medication in elderly patients.Methods Elderly patients discharged from the Department of Cardiovascular Medicine of Taizhou People’s Hospital from January to December 2023 were retrospectively analysed.Multifactorial logistic regression analysis was applied to analyse the factors affecting PIM according to the 2023 edition of the Beers criteria and the Criteria for Determining Potentially Inappropriate Medication Use in the Elderly in China(2017 edition).The incidence of PIM was compared by grouping patients by whether or not their wards involved clinical pharmacists.Results Among 1982 elderly patients,1518(76.59%)cases of PIM were screened by Beers’criteria,and 1276(64.38%)cases of PIM were screened by the Criteria for Judging Potentially Inappropriate Medication Use in the Elderly in China.The results of multifactorial logistic regression analyses showed that the number of disease species and the type of medication used by the patient were factors influencing the occurrence of PIM according to the 2023 edition of the Beers Criteria and the Criteria for Determining the Potentially Inappropriate Use of Medication in the Elderly in China(P<0.05).After the intervention of clinical pharmacists,the incidence of PIM was reduced(P<0.05).Conclusions The number of diseases and types of medication are factors that affect the occurrence of PIM,and clinicians and pharmacists should pay special attention to patients with multiple chronic diseases to reduce the risk of multiple medication use in the elderly.Clinical pharmacists’medication management for elderly patients discharged with medication is conducive to reducing the incidence of PIM and promoting rational clinical use of medication.

关 键 词：老年患者 心血管内科用药 潜在不适当用药 Beers标准 中国老年人潜在不适当用药判断标准 疾病种数 用药种类 

分 类 号：R972[医药卫生—药品]