基于2015版Beers标准评价老年患者潜在不适当用药

Evaluation of potentially inappropriate medication among aged patients by 2015 Beers Criteria

目的调查分析本院老年住院患者潜在不适当用药情况,探讨其老年患者不适当用药的可能的影响因素,为临床合理用药提供依据。方法以2015版Beers标准为依据,临床药师对本院243例老年住院患者潜在不适当用药进行评价,确定潜在不适当用药的发生率及影响因素。结果 78例(32.10%)存在与药物相关的潜在性不适当用药,18例(7.4%)存在与疾病或状态相关的潜在不适当用药,58例(23.8%)使用了老年患者慎用药物,16例(6.6%)存在非感染药物相互作用的潜在不适当用药。5例(2.0%)肾功能不全患者使用非抗感染药物。影响老年人发生潜在不适当用药的因素有年龄、疾病诊断数及合并用药数量。结论 Beers标准在评估老年患者潜在不适当用药中有重要价值,临床药师应合理借鉴和运用该标准,促进老年患者的合理用药,减少老年患者的用药风险。

Objective To analyze the potentially inappropriate medication（PIM）in the aged inpatients in our hospital, and to discuss the possible effects of inappropriate drug use in aged inpatients. Methods The potential inappropriate drug use of 243 aged inpatients in our hospital were evaluated according to 2015 Beers Criteria, and the incidence and influencing factors of potential inappropriate drug use were determined. Results 78 cases（32.10%）of potentially inappropriate medication（includ medicine with caution）were associated with drugs.18 cases（7.4%）were dependent on disease or conditions.58 cases（23.8%）used medicine which was needed to be caution for elder patients. 16 cases had interaction with non-anti-infective drugs. 5 cases with renal dysfunction（creatinine clearance rate（CrC1）30 ml/min）used non-anti-infective drugs. Among them, Spironolactone was treated with 4 cases and Rivaroxaban was treated with 1 case. The factors on potentially inappropriate drug use in elderly patients included age, number of disease diagnoses and combined use of drugs.Conclusions Beers Criteria is important in evaluating PIMs of aged patients. Clinical pharmacists should use medication reasonably to promote the rational use and to reduce the risk of inappropriate drug use for aged inpatients.