摘要
目的 促进老年2型糖尿病患者的安全、有效、合理用药。方法 回顾性分析江苏省盐城市第一人民医院内分泌科2019年7月至2020年6月收治的284例老年2型糖尿病患者的临床资料,依据老年人不适当处方筛查工具/老年人处方遗漏筛查工具(STOPP/START)标准对抽取病历的潜在不适当用药(PIM)进行评价,通过二元Logistic回归分析发生PIM的危险因素。结果 共纳入284份病历,男女比例为1∶1.09;平均年龄(72.78±6.42)岁;平均合并症数目(3.21±1.83)种,最常见的为高血压(64.79%);入院后平均用药数目为(13.71±5.12)种。PIM共181例次,其中潜在风险用药63例次(34.81%),特殊疾病状态67例次(37.02%),药物联用51例次(28.18%);潜在用药遗漏共105例次。单因素分析结果显示,年龄、疾病诊断数目、用药数目、合并甲状腺疾病、合并糖尿病肾病与PIM的发生显著相关(P <0.05);多因素分析结果显示,年龄不低于70岁[OR=2.009,95%CI(1.188,3.398),P=0.009],用药数目不少于15种[OR=1.853,95%CI(1.041,3.299),P=0.036],合并甲状腺疾病[OR=3.223,95%CI(1.156,8.982),P=0.025],合并糖尿病肾病[OR=2.425,95%CI(1.033,5.691),P=0.042]的患者PIM的发生风险较高。结论 老年2型糖尿病患者发生PIM的危险因素包括高龄、用药数目不少于15种、合并甲状腺疾病和糖尿病肾病,临床药师应重点关注此类患者。
Objective To promote safe,effective and rational drug use in elderly patients with type 2 diabetes mellitus(T2DM).Methods The clinical data of 284 elderly patients with T2DM admitted to the Department of Endocrinology in the Yancheng No.1 People's Hospital from July 2019 to June 2020 were retrospectively analyzed.The potentially inappropriate medication(PIM)in the medical records was evaluated according to the Screening Tool of Older Persons' Potentially Inappropriate Prescriptions/Screening Tool to Alert Doctors to the Right Treatment(STOPP/START) criteria.The risk factors for PIM were identified by binary logistic regression analysis.Results A total of 284 medical records were included,with a male-to-female ratio of 1∶1.09,and the patients' average age was(72.78 ± 6.42) years old.The average number of comorbidities was(3.21 ± 1.83) kinds,with hypertension being the most common(64.79%).After admission,the average number of used drugs was(13.71 ± 5.12) kinds.There were 181 cases of PIM reflected in potential risk medication(63 cases,34.81%),special disease conditions(67 cases,37.02%) and combined medication(51 cases,28.18%).There were 105 cases of potentially medication omissions.The results of univariate analysis showed that age,the number of diseases,the number of used drugs,complicated with thyroid disease and diabetic nephropathy were significantly related to the occurrence of PIM(P<0.05).The results of multivariate analysis showed that the patients with age ≥ 70 years old [OR = 2.009,95% CI(1.188,3.398),P = 0.009],with the number of used drugs ≥ 15 kinds[OR = 1.853,95% CI(1.041,3.299),P = 0.036],complicated with thyroid disease [OR = 3.223,95% CI(1.156,8.982),P = 0.025],complicated with diabetic nephropathy [OR = 2.425,95% CI(1.033,5.691),P = 0.042] had a higher risk of PIM.Conclusion Risk factors of PIM in elderly patients with T2DM include advanced age,≥ 15 kinds of drugs,complicated with thyroid disease and diabetic nephropathy.Clinical pharmacists should focus on these patients with risk facto
作者
吴慧
秦旸
卞海林
祁峰
孙柯倩
WU Hui;QIN Yang;BIAN Hailin;QI Feng;SUN Keqian(Yancheng First Hospital,Affiliated Hospital of Nanjing University Medical School·Yancheng No.1 People's Hospital,Yancheng,Jiangsu,China 224001;Dongtai Hospital of TCM,Yancheng,Jiangsu,China 224200;Dafeng People's Hospital of Yancheng,Yancheng,Jiangsu,China 224100)
出处
《中国药业》
CAS
2023年第19期141-145,共5页
China Pharmaceuticals
基金
江苏省盐城市医学科技发展计划项目[YK2021023]
江苏省药学会-天晴医院药学基金科研项目[Q202049]。
