Beers联合STOPP标准评估老年糖尿病多重用药患者潜在不恰当用药  

Evaluation of potentially inappropriate medications in elderly polypharmacy patients with diabetes mellitus according to Beers criteria combined with STOPP criteria

作　　者：常亚男 王娜[2] 张岩 CHANG Yanan;WANG Na;ZHANG Yan(College of Pharmacy,Hebei Medical University,Shijiazhuang 050017,China;Dept.of Pharmacy,the First Hospital of Qinhuangdao,Hebei Qinhuangdao 066000,China)

机构地区：[1]河北医科大学药学院,石家庄050017 [2]秦皇岛市第一医院药学部,河北秦皇岛066000

出　　处：《中国药房》2024年第24期3076-3080,共5页China Pharmacy

基　　金：河北省药学会医院药学专项科研项目(No.2022-Hbsyxhqjyxms16);秦皇岛市科学技术研究与发展计划项目(No.202301A141)。

摘　　要：目的为老年糖尿病患者安全用药提供参考。方法随机选取河北省两家三级综合医院2022年每个月1天中出院年龄≥65岁且长期用药≥5种的老年糖尿病患者的临床资料,分别采用2023版Beers标准和2023版老年人潜在不适当处方筛查工具(STOPP标准)对患者的潜在不适当用药(PIM)进行分析,采用多因素Logistic回归分析PIM的影响因素。结果共纳入227例患者。参照Beers标准,有157例患者(69.16%)检出PIM,检出PIM例次最多的药物有质子泵抑制剂(PPIs)、钠-葡萄糖耦联转运体2抑制剂和利伐沙班;参照STOPP标准,有142例患者(62.56%)检出PIM,主要涉及的药品为非甾体抗炎药和PPIs。多因素Logistic回归分析结果显示,年龄≥80岁、同时合并其他慢病数≥4种、长期用药数≥10种、住院天数≥8d、用药方案复杂性指数评分≥20分,以及合并高血压、冠心病、脑血管病均是发生PIM的影响因素。结论老年糖尿病患者PIM检出率较高,Beers标准对PIM的识别比STOPP标准更敏感;临床应重点关注高龄、同时合并多种慢病、长期用药数多、住院时间长、用药方案复杂的患者,加强对其合理用药管理。OBJECTIVE To provide a reference for the safe use of drugs in elderly patients with diabetes mellitus.METHODS Clinical data of elderly diabetic patients aged≥65 years old and with≥5 types of long-term medication who were admitted to two tertiary general hospitals in Hebei Province one day a month in 2022 were randomly selected.2023 Beers criteria and 2023 STOPP criteria were used to analyze the potentially inappropriate medication(PIM)of the patients;multivariate Logistic regression was used to analyze the influencing factors of PIM.RESULTS A total of 227 patients were included.According to the Beers criteria,157 patients(69.16%)had PIM,and the drugs with the most frequent cases of PIM were proton pump inhibitors(PPIs),sodium-glucose linked transporter-2 inhibitors and rivaroxaban.According to the STOPP criteria,142 patients(62.56%)had PIM,and the main drugs involved were non-steroidal anti-inflammatory drugs and PPIs.The results of multivariate Logistic regression analysis showed that patients with age≥80 years old,with≥4 other types of chronic diseases,≥10 types of long-term medication,≥8 days of hospitalization,medication regimen complexity index scoring≥20 points of medication regimen,and complication with hypertension,coronary heart disease,and cerebrovascular diseases were influential factors for PIM.CONCLUSIONS The detection rate of PIM is high in elderly patients with diabetes mellitus,and the Beers criteria are more sensitive to PIM than the STOPP criteria.Clinically,we should focus on patients who are elderly,have multiple chronic diseases at the same time,have a large number of long-term medications,have a long hospital stay,have complex medication regimens,and strengthen their rational drug management.

关 键 词：老年糖尿病 多重用药 潜在不适当用药 影响因素 合理用药 

分 类 号：R969.3[医药卫生—药理学]