老年住院患者潜在具有临床意义的药物相互作用:一项横断面研究  

Potentially clinically significant drug-drug interactions in elderly inpatients:a cross-sectional study

作　　者：刘璐[1] 钱文 王芳[1] 许静语 王静 桑翩翩 LIU Lu;QIAN Wen;WANG Fang;XU Jingyu;WANG Jing;SANG Pianpian(Department of Pharmacy,Huaibei People's Hospital Affiliated to Bengbu Medical University/Huaibei People's Hospital,Anhui Huaibei 235000,China)

机构地区：[1]蚌埠医学院直属淮北人民医院/淮北市人民医院药学部,安徽淮北235000

出　　处：《中国医院药学杂志》2025年第4期444-450,共7页Chinese Journal of Hospital Pharmacy

基　　金：淮北市科技计划项目(编号:2023HK036)。

摘　　要：目的:了解老年住院患者潜在具有临床意义的药物相互作用(potentially clinically significant drug-drug interactions,pcsDDIs)的发生情况及影响因素,为老年患者的临床用药安全提供重要依据。方法:检索淮北市人民医院电子病历系统2022年5月1—20日期间出院的老年患者(≥65岁),依据《老年人pcsDDIs国际共识列表》评估患者住院医嘱中的pcsDDIs发生情况,通过logistic回归分析pcsDDIs的危险因素。结果:共纳入856例老年患者,中位年龄74岁,其中413例(48.2%)患者至少发生1种pcsDDIs,发生例次较多的药物相互作用组合是同时使用≥2种保钾类药物(24.4%)。影响pcsDDIs的单因素有19个,多因素logistic回归发现药物过敏史,出院诊断总数量,年龄校正的查尔森合并症指数(age-adjusted Charlson comorbidity index,aCCI),合并脑梗死,合并高血压,合并心肌梗死,合并冠心病,合并心功能不全,合并房颤,西药品种数和使用生物制品是影响pcsDDIs发生的危险因素。结论:住院老年患者用药中pcsDDIs发生率较高,应警惕其潜在风险,加强老年患者合理用药的监测,优化医疗资源。OBJECTIVE To understand the occurrence of potentially clinically significant drug-drug interactions(pcsDDIs)in elderly inpatients and the factors affecting them,thus providing an important basis for the clinical drug safety in elderly patients.METHODS Discharged elderly patients(≥65 years old)in the electronic medical records system of Huaibei People's Hospital from May 1,2022,to May 20,2022 were retrieved.The occurrence of pcsDDIs was assessed by the inpatient medical orders based on the International Consensus List of pcsDDIs in Older People.Risk factors for pcsDDIs were analyzed by logistic regression.RESULTS A total of 856 elderly patients with a median age of 74 years were included,of whom 413(48.2%)had at least 1 pcsDDI.A concomitant use of more than 2 potassium-protecting drugs(24.4%)was the dominant pcsDDI.There were 19 single factors affecting pcsDDIs,and multifactorial logistic regression revealed that history of drug allergy,total number of discharge diagnoses,age-corrected Charlson comorbidity index(aCCI),comorbid cerebral infarction,comorbid hypertension,comorbid myocardial infarction,comorbid coronary artery disease,comorbid cardiac insufficiency,comorbid atrial fibrillation,number of Western medication varieties,and use of biologics were the risk factors.CONCLUSION The incidence of pcsDDIs in the medication of hospitalized elderly patients is high.The risk of drug interactions should be highlighted to strengthen the monitoring of the rational use of medication in elderly patients,and optimize medical resources.

关 键 词：老年患者 药物相互作用 发生率 影响因素 

分 类 号：R969.2[医药卫生—药理学]