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

Evaluation of potentially inappropriate medication in elderly inpatients by 2015 edition of Beers criteria

目的使用2015版Beers标准评价我院老年住院患者潜在不适当用药(Potentially inappropriate medication,PIM)的发生率,确定PIM发生的相关危险因素。方法本研究是回顾性的横断面研究,纳入人群为我院2017年3月出院的年龄≥65岁老年患者。使用2015版Beers标准来评价住院患者的PIM发生情况。使用Logistic回归分析确定PIM发生的相关危险因素。结果共纳入322例患者,平均年龄为(74.17±7.07)岁,平均住院天数(10.75±5.81)d,平均用药种类(13.12±8.41)种。200例(62.1%)至少存在1种PIM问题,其中最容易发生PIM的两类药物是苯二氮艹卓类和质子泵抑制剂。Logistic回归分析结果显示,心脏科、年龄75~84岁和住院期间使用药物种类≥6种更倾向于发生PIM。结论我院老年住院患者PIM发生率较高,需要引起我们的高度重视。对于老年住院患者,年龄75~84岁的PIM发生率最高;住院期间使用药物种类越多,PIM发生的几率越大;对于老年住院患者,用药更应该个体化,减少使用的药物种类,促进老年住院患者合理用药。

Objective To evaluate the prevalence of potentially inappropriate medication （PIM） in elderly in- patients in our hospital using the 2015 edition of Beers criteria,and determine the risk factors related to the prescription of PIM. Methods In the retrospective cross-sectional study,patients discharged from our hospital in March 2017 aged ≥65 years were included. The 2015 edition of Beers criteria was used to identify PIM. A Logistic regression study was used to identify the risk factors of PIM use. Results Totally 322 patients were included,aged （74. 17 ± 7. 07 ） ,the average hospital stay length was （0. 75 ± 5.81 ） d, and the average kinds of drug use were （ 13. 12 ±8.41 ）. Two hundred patients （62. 1% ） had at least one PIM, and the most prevalent PIM occurred in benzodiazepines and proton pump in- hibitors. Logistic regression analysis showed that PIM was more likely to occur in cardiology deparment,patient aged 75 - 84 and kinds of drug use being more than 6 species. Conclusion The prevalence of PIM in elderly patients in our hospital is high and needs to be paid much attention to. For elderly inpatients, those aged 75 - 84 has the highest preva- lence of PIM ; the more the species of drug use is, the greater the probability of occurrence of PIM becomes ; for elderly hospitalized patients, medication should be individualized to reduce the species of drugs use and promote the rational use of drug.