基于不同标准老年住院患者潜在不适当用药评价与分析

中国药物评价 ›› 2020, Vol. 37 ›› Issue (6): 460-464.

基于不同标准老年住院患者潜在不适当用药评价与分析

赵敏，黄承龙，黄振光

广西医科大学第一附属医院药剂科，广西南宁 530021

收稿日期:2020-10-10 修回日期:2020-11-06 出版日期:2020-12-28 发布日期:2020-12-28
基金资助:
广西高校中青年教师科研基础能力提升项目(2020KY03047)

Assessing Potentially Inappropriate Medications in Elderly Inpatients Based on Different Criteria

Deptment of Pharmacy， The First Affiliated Hospital of Guangxi Medical University， Guangxi Nanning 530021， China

Received:2020-10-10 Revised:2020-11-06 Online:2020-12-28 Published:2020-12-28
Contact: 赵敏 E-mail:zm_0642@163.com

摘要/Abstract

摘要： 目的：基于Beers标准（2019版）和《中国老年人潜在不适当用药判断标准》（2017版）分析我院老年科住院患者潜在不适当用药情况，并对其影响因素进行分析。方法：回顾性收集我院2020年1~6月年龄≥65岁的老年科住院患者的相关信息，分别用上述两种标准分析老年患者潜在不适当用药情况。利用Logistics回归分析确定其影响因素，kappa检验进行一致性评价。结果：共纳入患者278例，平均年龄(77.14±8.61)岁，平均住院天数为(10.42±5.04)天。依据Beers标准，178例（64.03%）患者存在潜在不适当用药；依据《中国老年潜在不适当用药判断标准》161例（57.91%）患者存在潜在不适当用药。两种标准的一致性一般，用药种类是发生潜在不适当用药的危险因素。结论：老年科住院患者PIM发生率较高，两种标准在评估PIM中均有重要参考意义，在临床应用中，应结合两种标准给出用药建议，确保用药安全。

关键词: font-size:medium, ">Beers标准；中国标准；潜在不适当用药；老年人

Abstract: Objective： To analyze the potentially inappropriate medications(PIM) among elderly inpatients using the Beers criteria of 2019 and the criteria of PIMs for older adults in China(Chinese criteria)， and to identify the correlates. Methods： The inpatients aged ≥65 years at geriatrics of our hospital from January to June， 2020 were included in this study. The Beers criteria of 2019 and the Chinese criteria were used to detect PIM. A multivariate logistic regression analysis was carried out to determine factors associated with the use of PIM. The concordance between the two criteria was calculated using kappa tests. Results： 278 inpatients were included. The average age of the geriatric patients was(77.14±8.61) years， and the length of stay was (10.42±5.04)days. The prevalence of PIM was 64.03% and 57.91% according to 2019 Beers criteria and the Chinese criteria， respectively. The two criteria indicated a moderate coherence. The factor associated with PIM by both criteria was the number of prescribed medications. Conclusion： Data showed a high PIM prevalence among the elderly inpatients. Two criterions both play a critical role in evaluating PIMs. In clinical applications， medication recommendations should be combined with the two criterions to ensure medication safety.

Key words: font-size:medium, ">Beers criteria； Chinese criteria； Potentially inappropriate medication； Elderly

中图分类号:

赵敏, 黄承龙, 黄振光. 基于不同标准老年住院患者潜在不适当用药评价与分析[J]. 中国药物评价, 2020, 37(6): 460-464.

ZHAO Min, HUANG Cheng-long, HUANG Zhen-guang. Assessing Potentially Inappropriate Medications in Elderly Inpatients Based on Different Criteria[J]. CHINESE JOURNAL OF DRUG EVALUATION, 2020, 37(6): 460-464.

参考文献

[1]陈珵.中国人口老龄化背景下的养老保险制度研究[J].中国集体经济，2020，13：165-166.
     [2]Beers MH， Ouslander JG， Rollingher I， et al. Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine[J]. Archives of internal medicine， 1991， 151(9)：1825-1832.
     [3]American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults[J]. J Am GeriatrSoc， 2019， 67(4)：674-694.
     [4]王赛，刘琛，张兰，等. 中国老年人潜在不适当用药判断标准(2017年版)[J].药物不良反应杂志，2018，20(1)：2-8.
     [5]李影影，邢玉晶，王烨，等. Beers标准和STOPP/START标准再评价老年住院患者医嘱点评情况[J].药学与临床研究， 2016， 24 (1)：57-60.
     [6]Jhaveri B N， Patel T K， Barvaliya M J， et al.Utilization of potentially inappropriate medications in elderly patients in a tertiary care teaching hospital in India[J]. PerspectClin Res， 2014， 5 (4)：184-189.
     [7]顾平，陈艳梅，李钟勇，等. 两种标准在老年住院患者潜在不适当用药评价中的应用分析[J].药学与临床研究，2019，27(1)：67-71.
     [8]徐鹏，张国柱.老年住院患者潜在不适当用药情况及影响因素[J].医药导报，2019，38(03)：388-391.
     [9]Zhuo Ma， Caixia Zhang， Xiangli Cui， et al. Comparison of three criteria for potentially inappropriate medications in Chinese older adults[J].Clinical Interventions in Aging， 2019，14：65-72.
     [10]侯凯旋，闫素英.2015版Beers标准在老年住院患者潜在不适当用药评价中的应用[J].实用药物与临床， 2018， 21(4)：452-456.
     [11]何丹，吴晓燕，董娜，等. 基于2019年版Beers标准分析评价某院老年住院患者潜在不适当用药[J].中国医院药学杂志，2019， 39(19)：1993-1999.
     [12]方甜甜，杨焕芝，段胜数，等. 采用《中国老年人潜在不适当用药目录》评价老年住院患者的用药合理性[J].中国药事，2018，32(12)：1684-1689.
     [13]中华医学会心血管病学分会，中华心血管病杂志编辑委员会.抗血小板治疗中国专家共识[J].中华心血管病杂志， 2013， 41 (3)：183-194.
     [14]张彩霞，孙瑞芳，马卓，等. 两种标准分析老年住院患者的潜在不适当用药[J].中国药事，2020，34(6)：700-706.
     [15]Oshima Tadayuki， Wu Liping， Li Min， et al. Magnitude and direction of the association between Clostridium difficile infection and proton pump inhibitors in adults and pediatric patients： a systematic review and meta-analysis[J]. Journal of Gastroenterology， 2018， 53(1)：84-94.
     [16]PradeepArora， Anu Gupta， MojganGolzy， et al. Proton pump inhibitors are associated with increased risk of development of chronic kidney disease[J]. BMC Nephrology， 2016， 17(1)：112-118.
     [17]Lai Shih-Wei， Liao Kuan-Fu. Association Between Proton Pump Inhibitors Use and Dementia Risk[J]. The American journal of gastroenterology， 2020， 115(4)：631.
     [18]中国药学会医院药学专业委员会.质子泵抑制剂优化应用专家共识[J].中国医院药学杂志, 2020, 40(21): 2195-2213.