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*
1. Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China; 2. Committee of Health and Family Planning of Dongcheng District, Beijing 100007, China; 3. Dongcheng District Community Health Service Management Center, Beijing 100010, China; 4. Office of the President, Peking University Health Science Center, Beijing 100191, China; 5. International Research Center for Medicinal Administration, Peking University, Beijing 100191, China; 6. Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
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.
�߱���,����Ԫ,л�����ᡤ��������,�ֺ�÷,����,���Ӻ�,������,ʷ¼��,������. �����ж������������껼��DZ�ڲ��ʵ���ҩ�о�[J]. �й�ҩѧ��־, 2019, 54(5): 415-419.
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. Chinese Pharmaceutical Journal, 2019, 54(5): 415-419.
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(ҩ�ﲻ����Ӧ��־), 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(ҩ�ﲻ����Ӧ��־), 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(�й����ҽҩ),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(�й���ҩ���ٴ���־),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(ҩѧ���ٴ��о�),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(�й�ҽԺҩѧ��־),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(�й��ٴ�ҩ��ѧ��־),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 (�й���ҩ���ٴ���־),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(ҽѧ�����),2011,24(8):42-45.
[18]
HU S L. Essential medicines system reform in China: achievements and challenges. Chin J Health Policy(�й����������о�),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(�й�ҽԺҩѧ��־), 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(ҩ�ﲻ����Ӧ��־), 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(�й�ҩѧ��־), 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(�й�ҩѧ��־), 2011, 46(12):966-968.
2019, Vol. 54 
