帕金森病合并非运动症状患者多重用药调查分析

Investigation of the poly-pharmacy in Parkinson's patients with non-motor symptoms

目的:调查北京宣武医院门诊处方中帕金森病合并非运动症状患者的用药趋势,为帕金森患者多重用药管理及风险防范提供依据。方法:收集2016年4-5月于北京宣武医院门诊神经科就诊的1443例帕金森病确诊患者的处方,随机抽取721份,分别统计帕金森病患者与帕金森病合并非运动症状患者的用药情况,包括性别、年龄、诊断、用药种类及频率。从审方药师的角度分析合并用药处方中存在的潜在问题以及合理性。结果:191例患者处方中具有帕金森病合并非运动性症状的相关诊断,主要包括焦虑/失眠(38.7%),抑郁/神经症(37.6%)等。59例患者(30.8%)处方用药至少包括1种或多种安定类药物,98例患者(51.3%)处方中开具了抗抑郁及抗焦虑药物。多数处方的药物应用合理,仍有部分处方中存在潜在的药物相互作用或用药风险。结论:帕金森病合并非运动症状患者普遍存在多重用药,该人群的药物治疗管理需要通过神经科医师、审方药师和临床药师团队的共同努力,确保用药安全有效。

Objective To investigate the trend of anti-Parkinson′s disease（PD） medication usage of PD outpatients with non-motor symptoms in Xuanwu Hospital Capital Medical University and provide reference to management and risk prevention in anti-Parkinson polypharmacy.Methods Seven hundred and twenty-one prescriptions were randomly selected from 1443 outpatient prescriptions of PD in the hospital from April to May in 2016.Prescriptions of parkinsonian outpatients with or without the diagnose of non-motor symptoms were studied retrospectively in the respects of gender,age,diagnosis,medication classification,and usage frequency.Rationality and potential safety problems in the prescriptions were evaluated from the viewpoint of prescription checking pharmacists.Results Among the 721 investigated PD outpatients,191 patients were co-diagnosed with non-motor symptoms such as anxiety/insomnia（38.7%）,depression/neurology（37.6%）; 59 patients（30.8%）were prescribed at least one sedative-hypnotic drugs; and 98 patients（51.3%）were prescribed with antidepressants and anxiolytics.The majority of co-medications was rational,however,the potential problems still exist in and should be noticed by clinical practitioners and checking pharmacists.Conclusion A considerable subset of investigated PD-patients was co-diagnosed with non-motor symptoms and was prescribed corresponding medications.A multidisciplinary intervention conducted by neurologist and clinical pharmacist could make contribution to ensure the safety of the polypharmacy in PD-patients with non-motor symptoms.