摘要
目的:基于两种标准评价厦门大学附属中山医院(以下简称“我院”)老年科多重用药的老年患者潜在不适当用药(potentially inappropriate medication,PIM)情况,探讨PIM的影响因素。方法:应用电子病例系统回顾性收集我院住院和门诊患者的相关信息,以2019版Beers标准与《中国老年人潜在不适当用药目录》(以下简称“中国PIM标准”)为依据评估PIM类型,并采用二元Logistic回归方法分析PIM的影响因素。结果:共纳入140例多重用药老年患者(住院患者69例,门诊患者71例),使用2019版Beers标准共检出41例患者(占29.29%)存在PIM,使用中国PIM标准共检出88例患者(占62.86%)存在PIM。Logistic回归分析结果显示,应用2019版Beers标准筛选出PIM的影响因素中,药物数量和年龄校正查尔森合并症指数(age-adjusted Charlson comorbidity index,aCCI)是危险因素(OR>1,P<0.05),内生肌酐清除率是保护因素(OR<1,P<0.05);应用中国PIM标准仅筛选出药物数量是PIM发生的危险因素(OR>1,P<0.05)。结论:2019版Beers标准与中国PIM标准存在一定差异,建议联合使用,临床上需关注用药数量和aCCI对发生PIM的风险,对老年患者多重用药应注重个体化用药管理。
OBJECTIVE:To evaluate the potentially inappropriate medication(PIM)in elderly patients with multiple drug use based on two criteria in the geriatrics department of Zhongshan Hospital Affiliated to Xiamen University(hereinafter referred to as“our hospital”),and to explore the influencing factors of PIM.METHODS:The electronic medical record system was used to retrospectively collect the relevant information of inpatients and outpatients in our hospital.Based on the Beers criteria(Version 2019)and the Chinese Catalogue of Potentially Inappropriate Medication for the Elderly(hereinafter referred to as the“Chinese PIM criteria”),the PIM types were evaluated,and the binary logistic regression method was used to analyze the influencing factors of PIM.RESULTS:A total of 140 elderly patients with multiple drugs(69 inpatients and 71 outpatients)were enrolled.Totally 41 patients(29.29%)were detected with PIM by using the Beers criteria(Version 2019),and 88 patients(62.86%)were detected with PIM by using the Chinese PIM criteria.Logistic regression analysis showed that among the influencing factors for PIM screened by the Beers criteria(Version 2019),drug quantity and age-adjusted Charlson comorbidity index(aCCI)were the risk factors(OR>1,P<0.05),and endogenous creatinine clearance was the protective factor(OR<1,P<0.05).According to Chinese PIM criteria,only drug quantity was screened as the risk factor for PIM(OR>1,P<0.05).CONCLUSIONS:There are certain differences between the Beers criteria(Version 2019)and the Chinese PIM criteria,it is recommended that the combination should be used.Clinically,the number of drugs used and the risk of aCCI for PIM should be paid attention to.For elderly patients with multiple drugs,individualized drug management should be attached more importance.
作者
郑灵招
林小青
温悦
吕佩瑜
欧阳华
ZHENG Lingzhao;LIN Xiaoqing;WEN Yue;LYU Peiyu;OUYANG Hua(Dept.of Pharmacy,Zhongshan Hospital Affiliated to Xiamen University,Fujian Xiamen 361004,China;School of Pharmacy,Fujian Medical University,Fujian Fuzhou 350000,China)
出处
《中国医院用药评价与分析》
2021年第8期995-999,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
关键词
老年患者
多重用药
Beers标准
中国老年人潜在不适当用药目录
Elderly patients
Multiple drug use
Beers criteria
Chinese Catalogue of Potentially Inappropriate Medication for the Elderly
