Abstract：OBJECTIVE To investigate and analyze the potential inappropriate medication(PIM) in elderly hospitalized patients in our hospital, explore the related risk factors, and analyze the use of PIM involved drugs in different departments, so as to provide reference for the formulation of medication manuals for the elderies in different departments and for further standardizing the use of drugs in elderly patients. METHODS The medical advice for elder patients(≥65 years old)hospitalised from January to October 2017 in our hospital was collected. Beers criteria of American Geriatrics Association 2019 was used as the reference to investigate and analyze PIM. And the risk factors of PIM were analyzed by logistic regression. RESULTS The average age of 12 756 elderly hospitalized patients was (74.13±6.88) years and the average number of diseases per patient was (3.22±2.09). For each patient, (4.79±3.76) kinds of medicines were used. According to the 2019 Beers criteria, the incidence of PIM was 20.00%. Among them, the central nervous system medications(6.41%,818/12 756) (estazolam tablets, alprazolam tablets) were the most frequently used. Data of PIM occurrence in different departments showed that the PIM incidence was higher in rheumatology, geriatrics, rehabilitation, anesthesia surgery and oncology departments. In addition, logistic regression analysis showed that gender, age, the number of combined medications and diseases, and length of stay were all potential risk factors for PIM. CONCLUSION The incidence of PIM in elderly hospitalized patients in our hospital is high. The rational drug use in elderly patients needs to be improved.
National Bureau of Statistics. China Statistical Yearbook (中国统计年鉴). Beijing:China Statistics Press, 2018:37.
[2]
Expert consensus on safety management of polypharmacy in the elderly. Chin J Diabetes (中国糖尿病杂志), 2018, 26(9):705-717.
[3]
JI L, HU D, PAN C, et al. Primacy of the 3B approach to control risk factors for cardiovascular disease in type 2 diabetes patients. Am J Med, 2013, 126(10):925 e11-e22.
[4]
ZHANG H X, CHEN X, LIU J C, et al. Potential inappropriate medication of elderly hospitalized patients in a certain hospital. Her Med(医药导报), 2018, 37(8):1004-1008.
[5]
BEERS M H, OUSLANDER J G, ROLLINGHER I, et al. Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine. Arch Intern Med, 1991, 151(9):1825-1832.
[6]
MARK H, BEERS M D. Explicit criteria for determining potentially inappropriate medication use by the elderly . Arch Intern Med, 1997, 157(14):1531-1536.
[7]
DONNA M, FICK P R, JAMES W, et al. Updating the Beers criteria for potentially inappropriate medication use in older adults. Arch Intern Med, 2003, 163 (22):2716-2724.
[8]
AMERICAN GERIATRICS SOCIETY 2012 BEERS CRITERIA UPDATE EXPERT PANEL. American geriatrics society updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc, 2012, 60 (4):616-631.
[9]
AMERICAN GERIATRICS SOCIETY 2015 BEERS CRITERIA UPDATE EXPERT PANEL. American geriatrics society 2015 updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc, 2015, 63(11):2227-2246. AMERICAN GERIATRICS SOCIETY 2019 BEERS CRITERIA UPDATE EXPERT PANEL. American geriatrics society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc, 2019, 67(4):674-694. KONGKAEW C, NOYCE P R, ASHCROFT D M. Hospital admissions associated with adverse drug reactions:a systematic review of prospective observational studies. Ann Pharmacother, 2008, 42(7):1017-1025. MORIARTY F, HARDY C, BENNETT K, et al. Trends and interaction of polypharmacy and potentially inappropriate prescribing in primary care over 15 years in Ireland:a repeated cross-sectional study . BMJ Open, 2015, 5(9):e008656. LAVAN A H, O'GRADY J, GALLAGHER P F. Appropriate prescribing in the elderly: current perspectives . World J Pharmacol, 2015, 4(2):193. HILL-TAYLOR B, SKETRIS I, HAYDEN J, et al. Application of the STOPP/START criteria:a systematic review of the prevalence of potentially inappropriate prescribing in older adults, and evidence of clinical, humanistic and economic impact . J Clin Pharm Ther, 2013, 38(5):360-372. HOLT S, SCHMIEDL S, THüRMANN P A. Potentially inappropriate medications in the elderly:the PRISCUS list . Dtsch Arztebl Int, 2010, 107(31-32):543-551. PETROVIC M, MARIMAN A, WARIE H. Is there arationale for prescription of benzodiazepines in the elderly? Review of the citerature . Acta Clin Belg, 2003, 58(1):27-36. CHINESE SLEEP RESEARCH SOCIETY. Guidelines for the diagnosis and treatment of insomnia in China. Natl Med J China (中华医学杂志), 2017, 97(24):1844-1856. GNJIDIC D, HILMER S N, BLYTH F M, et al. Polypharmacy cutoff and outcomes:five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes. J Clin Epidemiol, 2012, 65(9):989-995. JOHNELL K, KLARIN I. The relationship between number of drugs and potential drug-drug interactions in the elderly:a study of over 600,000 elderly patients from the Swedish Prescribed Drug Register . Drug Saf, 2007, 30(10):911-918. JIN F B, ZHENG H X, LIN L P, et al. Investigation and strategies for poly-pharmacy in the hospitalized senile oatients. J Zhejiang Chin Med Univ (浙江中医药大学学报), 2012,36(12):1360-1363.
2020, Vol. 55 
