北京市东城区社区老年患者潜在不适当用药研究

倪冰玉,傅孟元,谢克扎提·乌苏曼江,贾红梅,王芳,陈子豪,赵宜乐,史录文,管晓东

中国药学杂志 ›› 2019, Vol. 54 ›› Issue (5) : 415-419.

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中国药学杂志 ›› 2019, Vol. 54 ›› Issue (5) : 415-419. DOI: 10.11669/cpj.2019.05.011
论著

北京市东城区社区老年患者潜在不适当用药研究

  • 倪冰玉1,傅孟元1,谢克扎提·乌苏曼江1,贾红梅2,王芳3,陈子豪4,5,赵宜乐6,史录文1,5,管晓东1,5*
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Analysis of Potentially Inappropriate Medication Among Community Elderly Patients in Dongcheng District of Beijing

  • NI Bing-yu1, FU Meng-yuan1, XIEKEZHATI Wusumanjiang1, JIA Hong-mei2, WANG Fang3, CHEN Zi-hao4,5, ZHAO Yi-le6, SHI Lu-wen1,5, GUAN Xiao-dong1,5*
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摘要

目的 评价北京市东城区社区医疗机构老年人潜在不适当用药(potentially inappropriate medication,PIM)情况并探究其影响因素。方法 提取东城区社区医疗机构2017年60岁及以上老年患者门诊处方数据,依据《中国老年人潜在不适当用药判断标准(2017年版)》分析PIM基本情况和药物分布,采用Logistic模型分析PIM影响因素。结果 研究最终纳入1 045 269张处方,PIM发生率为12.9%;排名前三位的PIM药物为氯吡格雷(42.5%)、艾司唑仑(24.2%)和布洛芬(11.4%);Logistic回归结果显示,社区卫生服务中心、男性、初级职称医师,患病数、药品数较多、男性、高龄患者的PIM风险更高。结论 东城区社区医疗机构老年人PIM情况有待改善,推广老年人PIM判断标准,加强对于老年患者用药的风险评估具有重要意义。

Abstract

OBJECTIVE To evaluate the prevalence and risk factors of potentially inappropriate medication (PIM) among elderly inpatients in community health care institutions in Dongcheng district. METHODS The outpatient prescriptions of patients aged 60 and above in community health care institutions in Dongcheng district in 2017 were analyzed. The proportion of PIM prescriptions and the utilization rate of PIM drugs were calculated according to the criteria of potentially inappropriate medications for older adults in China (2017). Logistic model was built to analyze the influence factors of PIM. RESULTS The 1 045 269 prescriptions were collected in this study. The 12.9% prescriptions had at least one PIM prescribed. The top 3 drugs in PIM prescriptions were clopidogrel (42.5%), estazolam (24.2%) and ibuprofen (11.4%). The logistic regression analysis revealed that the significant predictors for PIM prescription were: visits of healthcare center; doctors′ male gender and lower-class title; patients′ male gender, elder age, more illness and more drugs. CONCLUSION The situation of PIM prescriptions needs to be improved for the elderly inpatients in community health care institutions in Dongcheng district. To reduce the incidence of PIM in elderly patients, the criteria of potentially inappropriate medications for older adults in China requires further promotion.

关键词

老年患者 / 药物使用 / 潜在不适当用药 / 社区医疗机构 / 中国老年人潜在不适当用药判断标准

Key words

elderly patient / drug utilization / potentially inappropriate medication / community health care institution / criteria of potentially inappropriate medications for older adults in China

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倪冰玉,傅孟元,谢克扎提·乌苏曼江,贾红梅,王芳,陈子豪,赵宜乐,史录文,管晓东. 北京市东城区社区老年患者潜在不适当用药研究[J]. 中国药学杂志, 2019, 54(5): 415-419 https://doi.org/10.11669/cpj.2019.05.011
NI Bing-yu, FU Meng-yuan, XIEKEZHATI Wusumanjiang, JIA Hong-mei, WANG Fang, CHEN Zi-hao, ZHAO Yi-le, SHI Lu-wen, GUAN Xiao-dong. Analysis of Potentially Inappropriate Medication Among Community Elderly Patients in Dongcheng District of Beijing[J]. Chinese Pharmaceutical Journal, 2019, 54(5): 415-419 https://doi.org/10.11669/cpj.2019.05.011
中图分类号: R951   

参考文献

[1] SAMUEL M J. American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc, 2015, 63(11):2227-2246.
[2] MAIO V, JUTKOWITZ E, HERRERA K, et al. Appropriate medication prescribing in elderly patients: how knowledgeable are primary care physicians? A survey study in Parma, Italy. J Clin Pharm Ther, 2011, 36(4):468-480.
[3] BERGKVIST A, MIDLOV P, HOGLUND P, et al. A multi-intervention approach on drug therapy can lead to a more appropriate drug use in the elderly. LIMM-Landskrona Integrated Medicines Management. J Eval Clin Pract, 2009, 15(4):660-667.
[4] FADARE J O, DESALU O O, OBIMAKINDE A M, et al. Prevalence of inappropriate medication prescription in the elderly in Nigeria: a comparison of Beers and STOPP criteria. Int J Risk Saf Med, 2015, 27(4):177-189.
[5] RATIONAL DRUG USE BRANCH OF CHINESE ASSOCIATION OF GERIATRIC RESEARCH. Criteria of potentially inappropriate medications for older adults in China (2017). Adv Drug React J(药物不良反应杂志), 2018,20(1):2-8.
[6] LI X W, SHEN Q, LI X L, et al. Investigation on situation of potentially inappropriate medication before and after pharmacist intervention in elderly patients in Beijing primary health care institutions. Adv Drug React J(药物不良反应杂志), 2015,17(2):117-120.
[7] MILLER G E, SARPONG E M, DAVIDOFF A J, et al. Determinants of potentially inappropriate medication use among community-dwelling older adults. Health Serv Res, 2017, 52(4): 1534-1549.
[8] BLOZIK E, RAPOLD R, VON O J, et al. Polypharmacy and potentially inappropriate medication in the adult, community-dwelling population in Switzerland. Drug Aging, 2013, 30(7):561-568.
[9] CANO-GUITIERREZ C, SAMPER-TERNENT R, CABRERA J, et al. Medication use among older adults in Bogota, Colombia. Rev Peru Med Expe Salud Publica, 2016, 33(3): 419-424.
[10] ALLEGRI N, ROSSI F, DEL SIGNORE F, et al. Drug prescription appropriateness in the elderly: an Italian study. Clin Interv Aging, 2017, 12:325-333.
[11] YE T T, LIN B L, SU Y F. Analysis on potential inappropriate drug use in elderly outpatients in 2015. Chin J Rural Med Pharm(中国乡村医药),2017,24(5):53-55.
[12] BIAN Y, LI G, YANG Y, et al. Evaluation on elderly outpatient medication rationality with elderly potentially inappropriate medication primary judgment standards. Chin J New Drugs Clin Rem(中国新药与临床杂志),2015,34(1):68-72.
[13] WU Q H, ZHANG G F, ZHANG H X, et al. Evaluation and improvement strategies of potential inappropriate medication in elderly patients in our hospital. Pharm Clin Res(药学与临床研究),2017,25(3):248-250.
[14] DUAN R, LI Z X. Evaluation of potential inappropriate medication in hospitalized elderly patients based on two criteria. Chin J Hosp Pharm(中国医院药学杂志),2017,37(19):1979-1982,2000.
[15] CAI J, NIE L, ZHANG H X, et al. Evaluation of irrational drug use in elderly inpatients based on the list of potentially inappropriate medication for the Chinese aged people. Chin J Clin Pharmcol(中国临床药理学杂志),2018,34(3):375-377.
[16] BIAN Y, CAI L L, LONG E W, et al. Evaluation of potentially inappropriate medication use in elderly patients by 2015 Beers Criteria. Chin J New Drugs Clin Rem (中国新药与临床杂志),2016,35(10):751-758.
[17] ZHENG D X. Thought on building the specialized cooperation mechanism between public hospitals and gross-root medical institution under the background of new medical reform. Med Soc(医学与社会),2011,24(8):42-45.
[18] HU S L. Essential medicines system reform in China: achievements and challenges. Chin J Health Policy(中国卫生政策研究),2012,5(7):1-5.
[19] HE M, SHAO X, ZHAO Y, et al. Comparison of the Beers criteria, STOPP/START criteria and Chinese potentially inappropriate medication primary judgment criteria in evaluating prescription orders in cardiovascular department. Chin J Hosp Pharm(中国医院药学杂志), 2018,38(7): 781-784,791.
[20] BHATT D L, FOX K A, HACKE W, et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. New Engl J Med, 2006, 354(16):1706-1717.
[21] LIANG H Y, ZHANG L, XING X X, et al. Analysis on prevalence and influencing factors of potentially inappropriate medication in elderly patients in outpatient and emergency departments in China. Adv Drug React J(药物不良反应杂志), 2017, 19(1):22-30.
[22] WEN J, CHENG Y, HU X, et al. Workload, burnout, and medical mistakes among physicians in China: a cross-sectional study. Biosci Trends, 2016, 10(1):27-33.
[23] YOUSEFI N, MAJDZADEH R, VALADKHANI M, et al. Reasons for physicians′ tendency to irrational prescription of corticosteroids. Iran Red Crescent Med, 2012, 14(11):713-718.
[24] SUN J X, ZHOU Q X, YUE S M. Survey on the prevalence of chronic diseases and the demands of pharmaceutical care in elderly population in China. Chin Pharm J(中国药学杂志), 2016, 51(2):155-158.
[25] YUAN Y H, ZHANG B, MEI D. Drug related problems and drug administration in the elderly. Chin Pharm J(中国药学杂志), 2011, 46(12):966-968.

基金

北京市东城区社区卫生服务管理中心“社区合理用药综合能力提升项目”资助
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