摘要
目的 探究失能老年住院患者潜在不适当用药(PIM)与共病、衰弱、跌倒的关系。方法 采用随机抽样,选取2017年2月—2019年2月于我院住院治疗的失能老年患者200例作为研究对象。按照中国老年人PIM目录(2017版)将所有研究对象分为PIM组(n=133)与非PIM组(n=67)。比较2组患者基本资料、生化指标水平、跌倒发生情况等,并进行统计分析。结果 PIM组研究对象年龄高于非PIM组,服药数量多于非PIM组,跌倒发生率高于非PIM组(P<0.05);PIM组研究对象步速降低率、察尔森公布指数(CCI)评分、衰弱量表评分均高于非PIM组,而Barthel Index日常生活能力量表(ADL)与Lawton工具性日常生活能力量表(IADL)评分均低于非PIM组(P<0.05)。将研究对象PIM情况作为因变量,将年龄、服药数量、跌倒率、步速降低、ADL评分、IADL评分、CCI评分及衰弱量表评分作为自变量,进行多因素Logistic回归分析,结果显示:服药数量是研究对象发生PIM的独立危险因素(P<0.05)。结论 失能老年住院患者PIM的发生与共病、衰弱、跌倒存在一定关系,且服药数量多是老年住院患者发生PIM的独立危险因素,临床医护人员应重视PIM问题,加强合理用药意识,尽量减少患者服用药物数量。
Objective To investigate the relationship among potentially inappropriate medication(PIM),co-morbidities,asthenia,and falls in disabled elderly inpatients.Methods A total of 200 disabled elderly patients hospitalized in Jiamusi Central Hospital from February 2017 to February 2019 were selected as study participants by random sampling.All subjects were assigned to a PIM group(n=133) and a non-PIM group(n=67) following the Chinese Potentially Inappropriate Medication List for Older Adults(2017 Edition).The basic data,biochemical indicators,and the occurrence of falls were compared between the two groups.Statistical analysis was performed.Results The age of the participants in the PIM group was higher than that in the non-PIM group;the number of medications in the PIM group was higher than that in the nonPIM group;the incidence of falls in the PIM group was higher than that in the non-PIM group,with statistical significance(P<0.05).The rate of gait speed reduction,the Charlson Comorbidity Index(CCI) score and weakness scale score in the PIM group were higher than those in the non-PIM group,while the Barthel Index Activities of Daily Living Scale(ADL) and Lawton Instrumental Activities of Daily Living Scale(IADL) scores were significantly lower than those in the non-PIM group(P<0.05).Multivariate logistic regression analysis was performed with participants’ PIM as the dependent variable and age,number of medications,fall rate,decreased gait speed,ADL score,IADL score,CCI score,and frailty scale score as independent variables.The results indicated that the number of medications was an independent risk factor for PIM among the participants(P<0.05).Conclusion The occurrence of PIM in disabled elderly inpatients is related to comorbidity,asthenia,and falls.The number of medications is an independent risk factor for PIM in elderly inpatients.Clinical medical staff should pay attention to PIM problems,strengthen the awareness of rational drug use,and minimize the number of medications taken by patients.
作者
侯丽晖
侯丽欣
昝佳
梁爽
Hou Lihui;Hou Lixin;Zan Jia;Liang Shuang(Outpatient Department,Jiamusi Central Hospital,Jiamusi Heilongjiang 154000,China)
出处
《保健医学研究与实践》
2022年第12期20-23,27,共5页
Health Medicine Research and Practice
关键词
失能老年人
不适当用药
共病
衰弱
跌倒
Disabled elderly
Inappropriate medication
Comorbidity
Asthenia
Fall
