中国城镇老年慢性病患者居家安全用药现状调查与影响因素分析:一项基于全国多中心的研究  

Survey of current status of home medication safety among elderly patients with chronic diseases in urban China:a nationwide multi-center study on influencing factors

作　　者：马慧艳 赵志刚[2] 乔春凤 葛姝 周博雅 李茜茜 陈淑敏 武明芬 MA Hui-yan;ZHAO Zhi-gang;QIAO Chun-feng;GE Shu;ZHOU Bo-ya;LI Qian-qian;CHEN Shu-min;WU Ming-fen(Department of Pharmacy,Zhengzhou Yihe Hospital,Zhengzhou 450018;Department of Pharmacy,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070;School of Social and Population,Renmin University of China,Beijing 100872;Department of Pharmacy,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100006;Department of Pharmacy,Beijing Chest Hospital,Capital Medical University,Beijing 101149)

机构地区：[1]郑州颐和医院药剂科,郑州450018 [2]首都医科大学附属北京天坛医院药学部,北京100070 [3]中国人民大学社会与人口学院,北京100872 [4]首都医科大学附属北京妇产医院药事部,北京100006 [5]首都医科大学附属北京胸科医院药学部,北京101149

出　　处：《中南药学》2024年第10期2696-2701,共6页Central South Pharmacy

基　　金：国家卫生健康委药具管理中心药品使用说明书适老化研究项目(No.国卫药管ZDC202201)。

摘　　要：目的调查中国城镇老年慢性病患者居家安全用药现状,分析影响安全用药的因素,为制订有效的居家用药管理措施提供依据。方法制订统一电子问卷,由药师上门以居家药学服务的方式收集患者信息,问卷由药师在线填写,结果以Excel导出。采用描述性统计和Logistic回归对调查结果进行分析。结果共收集到8417份有效问卷。回归分析结果显示,教育水平、饮酒、工作状态、就医方便性、能否看得懂说明书、是否听说过用药指导服务、存储理念是否来自说明书、是否知道过期药品回收箱、是否有不再服用的慢性病药品是家庭药品存储合理性的主要影响因素(P<0.05)。患者家庭药箱存在多种用药安全风险:如未定期清理药箱(24.03%)、药品存储不适宜(12.56%)、存在过期药品(34.05%)及变质药品(6.78%)、过期药品处理不当(90.52%)、存有不再继续服用的慢性病用药(69.28%)等。75.63%的患者对药品适应证了解不足,对药学服务有着迫切需求,服务方式更倾向于药师上门开展居家药学服务(23.01%)或开设药师门诊(22.57%)。结论我国老年慢性病患者家庭存在多种安全用药风险,应积极推广居家药学服务,并根据风险因素制订有效的药学干预措施。Objective To investigate the current situation of home medication safety among elderly patients with chronic diseases in urban China,analyze the influence factors for safe medication use,and provide a basis for effective home management measures.Methods A unified electronic questionnaire was developed,and patient information was collected by pharmacists during home pharmaceutical service.The questionnaire was filled out online by pharmacists,and the results were presented in Excel.Descriptive statistics and Logistic regression were used for the analysis.Results Totally 8417 valid questionnaires were collected.The regression analysis showed that educational level,drinking,working status,convenience of medical treatment,ability to understand instructions,awareness of medication guidance service,alignment of storage with instructions,knowledge of medication expiration disposal,knowledge of indication,and the presence of unused medications were the main influence factors for the rationality of home medication storage(P<0.05).There were various medication safety risks in patients’home medicine cabinets,such as irregular cleaning of the medicine cabinet(24.03%),inappropriate medication storage(12.56%),presence of expired medications(34.05%)and deteriorated medications(6.78%),improper handling of expired medications(90.52%),and having chronic disease drugs that were no longer taken(69.28%),etc.About 75.63%of the patients had insufficient knowledge of medication indications and had an urgent need for pharmaceutical service,with a preference of pharmacists,home service(23.01%)or pharmacist clinic consultation(22.57%).Conclusion There are various medication safety risks in the households of elderly patients with chronic disease in China.Home pharmaceutical service and effective timely pharmaceutical intervention measures based on risk factors are expected.

关 键 词：城镇 老年 慢性病 家庭药箱 居家安全用药 调查 

分 类 号：R95[医药卫生—药学] R969.3