某院门诊老年患者多重用药现状及分析  

Current status and analysis of polypharmacy among elderly outpatients in a certain hospital

作　　者：黄荔美 HUANG Li-mei(Department of Pharmacy,Putian No.95 Hospital,Futian,Putian 351100,China)

机构地区：[1]莆田九十五医院药学科,351100

出　　处：《中国现代药物应用》2024年第15期132-135,共4页Chinese Journal of Modern Drug Application

摘　　要：目的调查分析某院门诊老年患者的多重用药情况,并提出药学干预对策。方法于2022年每月定期从医院处方系统中调取门诊收治的老年患者处方,对患者处方进行用药点评,并通过电话随访调查患者用药情况,比较两组门诊老年患者基本信息、门诊老年患者对所用药品的知晓情况,以及门诊多重用药患者的常见疾病及常用药情况、门诊多重用药患者的潜在不适当用药(PIM)情况。结果纳入研究的673例门诊老年患者处方中共188例多重用药患者,占比27.9%,多重用药组的老年患者年龄(74.61±5.26)岁、诊断疾病数(3.35±1.70)种、用药种数(8.22±2.30)种均显著高于非多重用药组的(72.52±4.93)岁、(1.76±1.15)种、(3.10±1.20)种,Morisky服药依从性量表(MMAS-8)评分(5.32±1.05)分显著低于非多重用药组的(6.63±0.52)分(P<0.05)。门诊多重用药组的老年患者对药品作用,用药剂量和时间,药品不良反应,禁忌、注意事项内容的知晓率分别为81.9%、85.6%、75.5%、64.9%,均显著低于非多重用药组的93.0%、95.1%、84.9%、80.0%(P<0.05)。调查显示,门诊多重用药组老年患者中,最常见的10种疾病依次为睡眠障碍53.7%(101/188)、高血压31.9%(60/188)、糖尿病22.9%(43/188)、血脂异常18.1%(34/188)、上呼吸道感染17.0%(32/188)、慢性胃炎或溃疡16.0%(30/188)、骨关节病15.4%(29/188)、骨质疏松12.2%(23/188)、慢性肺部疾病11.7%(22/188)、冠心病10.6%(20/188)。基于《中国老年人潜在不适当用药判断标准(2017年版)》,共识别出175次药物相关PIM,未发现疾病状态下PIM的发生,其中45例患者至少发生了1项PIM,发生率为23.9%,其中PIM次数排名前3的药物为氯吡格雷45次、艾司唑仑42次、硝苯地平31次。结论门诊老年患者普遍存在多重用药情况,多重用药患者依从性不高,存在较高的PIM发生率,需针对该类患者提供相应的药学服务,以提高用药安全性。Objective To investigate and analyze the polypharmacy of elderly outpatients in a hospital,and put forward pharmaceutical intervention countermeasures.Methods In 2022,prescriptions of elderly patients admitted to the outpatient clinic were retrieved from the hospital prescription system on a monthly basis,medication reviews were conducted on the patients'prescriptions,and the patients'medication use was investigated through telephone follow-up.Comparison was made on the basic information of two groups of elderly outpatient patients,their knowledge of the drugs used,as well as the common diseases and commonly used drugs in outpatient polypharmacy patients,and the potential inappropriate medication(PIM)in outpatient polypharmacy patients.Results A total of 673 elderly patients were investigated in the outpatient department,of which 188 were polypharmacy patients,accounting for 27.9%.Compared with(72.52±4.93)years,(1.76±1.15)kinds and(3.10±1.20)types in non-polypharmacy group,polypharmacy group had a higher age of(74.61±5.26)years,more diagnosed diseases of(3.35±1.70)kinds,and higher number of drug use of(8.22±2.30)types;but lower 8-Item Morisky Medication Adherence Scale(MMAS-8)scores of(5.32±1.05)points than(6.63±0.52)points in non-polypharmacy patients(P<0.05).The percentage of elderly patients who were aware of drug action,drug dosage and time,adverse drug reactions,contraindications,and precautions were 81.9%,85.6%,75.5%and 64.9%in polypharmacy group,which were significantly lower than 93.0%,95.1%,84.9%and 80.0%in non-polypharmacy group(P<0.05).The survey showed that the 10 most common diseases in elderly patients of polypharmacy group were,in order,sleep disorders 53.7%(101/188),hypertension 31.9%(60/188),diabetes mellitus 22.9%(43/188),dyslipidemia 18.1%(34/188),upper respiratory tract infections 17.0%(32/188),chronic gastritis or ulcers 16.0% (30/188), osteoarthrosis 15.4% (29/188), osteoporosis 12.2% (23/188), chronic lung disease 11.7% (22/188), coronary heart disease 10.6% (20/188). Based on the "

关 键 词：多重用药 老年人 潜在不恰当用药 合理用药 用药依从性 

分 类 号：R95[医药卫生—药学]