基于Beers标准和STOPP/START标准评价老年消化道疾病的潜在不适当用药

The evaluation on potentially inappropriate medications in elderly patients with the digestive tract diseases by using Beers and STOPP/START criteria

目的了解老年患者消化道疾病的潜在不恰当用药,为老年患者消化道疾病的临床用药提供借鉴。方法提取在老年医学科住院的285例患者病历,依据Beers标准和STOPP/START标准,对消化道疾病存在的潜在不恰当用药情况进行筛查。结果依据Beers标准,285例患者病历中有61例(21%)存在潜在不适当用药,共计85项。按照STOPP标准,285例患者病历中23例(8%)筛查出潜在不适当用药,共计39项;按照START标准,筛查出16例(6%)患者病历存在处方遗漏情况,共计16项; 50例(18%)患者存在Beers标准和STOPP/START标准未包括的潜在不适当用药(PIMs);影响老年消化道疾病患者发生PIMs的因素包括:年龄、疾病种类、住院时间、用药种类、日常生活能力量表评分(ADL)。结论老年患者消化道疾病存在潜在不恰当用药,易导致PIMs的影响因素较多,使用Beers标准和STOPP/START标准对老年消化道疾病患者的用药进行评估,能有效降低PIMs发生,提高老年消化道疾病诊疗的医疗质量。

Objective To evaluate potentially inappropriate medications （PIMs） in elderly patients with diges- tive tract diseasesand provide amirror for clinical work in elderly patients. Methods The medical recordsof patients on geriatric medicine were collected and PIMs were evaluated by using Beers and STOPP/START criteria. Results The Beers criteria identified 85 PIMs in 21% （61） of the patients. The STOPP criteria identified 39 PIMs in 8% （23） of the patients. The START criteria identified potential prescribing omissions in 6% （16） of the patients. 18% （50） of the patients identified PIMs were not included in the Beers criteria and the STOPP/START criteria, Influence factors of PIMs in elderly patients with digestive diseases include age, variety of disease, hospital stays, the amount of medication and ADL. Conclusion PIMs in elderly patients with digestive tract diseases are universal and there are many ilffluence fac- tors. Evaluating PIMs in elderly patients with digestive tract diseases using the Beers and STOPP/START criteria can ef- fectively decrease medical risk and improve the quality of medical care.