摘要
目的 采用三种标准评估某院老年多重用药住院患者潜在不适当用药(potentially inappropriate medication,PIM)情况,为指导临床合理用药提供依据.方法 收集2022年我院老年医学科多重用药患者病历信息,以2019版Beers标准、老年人不适当处方筛查工具(STOPP)/老年人处方遗漏筛查工具(START)第二版(简称"STOPP/START标准")及中国老年人潜在不适当用药判断标准2017版(简称"中国标准")为评估依据对用药医嘱进行分析.结果 共纳入378例老年多重用药住院患者,平均年龄(74.76±8.64)岁,平均疾病诊断数(11.11±3.89)种,平均用药品种数为(12.04±4.81)种.Beers标准筛查出PIM475例,PIM例次前三位的药物是阿司匹林、阿普唑仑、利尿剂;STOPP标准筛查出PIM285例,START标准筛查出处方遗漏143例,中国标准筛查出PIM563例,PIM例次前三位的药物是氯吡格雷、阿普唑仑、异丙嗪.结论 三种标准侧重点有所不同,筛查结果存在一定差异,建议三种标准联合使用,以提高PIM检出率,减少药物不良反应和相互作用的风险,提高治疗效果,保障老年住院患者的用药安全.
Objective To evaluate the potentially inappropriate medication(PIM)usage among elderly inpatients with multiple medications at a certain hospital using three criteria,providing a basis for guiding rational clinical medication practices.Methods Based on the 2019 Beers criteria,the second edition of the Screening Tool of Older Persons'Prescriptions(STOPP)and the Screening Tool to Alert to Right Treatment(START)criteria(collectively referred to as the"STOPP/START criteria"),and the 2017 version of criteria of potentially inappropriate medications for older adults in China(referred to as the"Chinese criteria"),medication orders were analyzed.Results A total of 378 elderly patients with multiple medications were included in the study,with an average age of(74.76±8.64)years,an average number of(11.11±3.89)diagnoses,and the average number of the types of drug used were(12.04±4.81).The Beers criteria screened 475 cases of PIM,and the top three drugs for PIM cases were aspirin,alprazolam,and diuretics.The STOPP criteria screened 285 cases of PIM,the START criteria screened 143 cases of prescription omissions.The Chinese criteria screened 563 cases of PIM,and the top three drugs for PIM cases were clopidogrel,alprazolam,and promethazine.Conclusion The three criteria have different focus areas and yield different results.It is recommended to use all three criteria in combination to improve PIM detection rates,reduce the risk of adverse drug reactions and interactions,enhance treatment efficacy,and ensure medication safety for elderly hospitalized patients.
作者
张玲
樊星花
兰天
Zhang Ling;Fan Xinghua;Lan Tian(Liuzhou workers'hospital,Liuzhou,Guangxi 545007,China)
出处
《首都食品与医药》
2024年第23期91-95,共5页
Capital Food Medicine
基金
广西药学会医院药学科研项目(编号:GXYXH1-202211)。
