高龄非瓣膜性心房颤动患者新型口服抗凝药物的潜在不适当用药研究  

Evaluation of potentially inappropriate medication of novel oral anticoagulant in elderly patients with non-valvular atrial fibrillation

作　　者：王研 田薇薇 朱海斌 余自成 WANG Yan;TIAN Weiwei;ZHU Haibin;YU Zicheng(Department of Pharmacy,Tongji University Affiliated Yangpu Hospital,Shanghai 200090,China)

机构地区：[1]同济大学附属杨浦医院药学部,上海200090

出　　处：《药物流行病学杂志》2025年第1期21-26,共6页Chinese Journal of Pharmacoepidemiology

摘　　要：目的 评价新型口服抗凝药物(NOACs)在高龄非瓣膜性心房颤动(NVAF)患者治疗中的应用,为临床合理用药提供依据。方法 依据2023版Beers标准,结合药品说明书及相关指南,制订NOACs在NVAF患者中的潜在不适当用药(PIM)评价标准,分析2023年1—12月在心血管内科住院且年龄≥80岁的患者使用NOACs时的PIM情况。结果共纳入病例78例,共发生NOACs相关的PIM 47例次,其中肾功能相关PIM 1例次,药物相互作用相关PIM 46例次。72例患者不符合2023版Beers标准评价原则。结论 更新后的Beers标准尚未在临床中普及。高龄NVAF患者使用NOACs发生较多的PIM是药物相互作用。应加强对高龄NVAF患者的用药监测,促进合理用药。Objective To evaluate the application of novel oral anticoagulants(NOACs)in the treatment of elderly patients with non-valvular atrial fibrillation(NVAF),and to provide a basis for the rational use of drugs in clinical practice.Methods Based on the Beers criteria(2023 edition),combined with drug instructions and relevant guidelines,the potential inappropriate medication(PIM)evaluation criteria of NOACs in NVAF patients were formulated.The medication PIM of patients aged 80 years or older who were hospitalized in the cardiovascular department from January to December 2023 was analyzed when using NOACs.Results A total of 78 cases were included,and 47 cases of PIM occurred in NOACs,including 1 case of renal function-related PIM(2.13%),and 46 cases of drug interaction related PIM(97.87%).There were 72 patients who do not meet the evaluation criteria of the 2023 version of the Beers standard.Conclusion The updated Beers standard has not yet been widely adopted in clinical practice.The highest incidence of PIM in the use of NOACs in elderly patients with NVAF is due to drug interactions.It is necessary to strengthen drug monitoring in elderly patients with NVAF and promote rational drug use.

关 键 词：新型口服抗凝药 高龄患者 非瓣膜性心房颤动 潜在不适当用药 

分 类 号：R973.2[医药卫生—药品]