精神科门诊老年患者潜在不适当用药情况分析

Analysis of Potentially Inappropriate Medications in Elderly Outpatients of Psychiatry Department

目的调查分析精神科门诊老年(≥60岁)患者潜在不适当用药情况。方法采用回顾性横断面调查的方法,收集2018年7月9日—7月13日精神科门诊老年患者的人口统计学、临床诊断、用药情况等资料。采用中国老年人PIM目录(2017年版)分析处方PIM情况。结果共收集1 029例研究对象,年龄为(69.2±7.9)岁,与药物相关的PIM有713例(69.29%),其中A级警示药物有687例次(68.63%),B级警示药物314例次(31.37%);高风险强度有407例次(40.66%),低风险强度有594例次(59.34%)。PIM发生率较高的药物有奥氮平、氯硝西泮、喹硫平、劳拉西泮、利培酮、艾司唑仑。疾病状态下发生的PIM涉及癫痫和痴呆或认知功能受损,涉及药物有奥氮平、阿普唑仑、艾司唑仑等。结论精神科门诊老年患者PIM发生比例较高,应当引起重视,加强管理和信息化建设,提高老年人安全合理用药水平。

Objective To investigate potentially inappropriate medication(PIM)in elderly outpatients of psychiatry department.Methods Method of retrospective cross-sectional investigation was applied in the study.Data of demography,clinical diagnosis and drug use of elderly outpatients in psychiatric department were collected from July 9 to July 13,2018.And the PIMs were evaluated according to the criteria of potentially inappropriate medications for older adults in China(2017 version).Results A total of 713(69.29%)out of 1 029 outpatients,aged(69.2±7.9),got medication-related PIMs,with 687(68.63%)cases preferred alert medications(A),314(31.37%)cases routinely alert medications(B),407(40.66%)cases of high-risk medications and 594(59.34%)cases under low risk medications.The medications with higher PIM incidence were olanzapine,clonazepam,quetiapine,lorazepam,risperidone and esazolam.PIM in the elderly under morbid state contained epilepsy and dementia or cognitive impairment,involving drugs such as olanzapine,alprazolam and astazolam.Conclusion A high ratio of PIM existed in psychiatric outpatients,which should be paid more attention to.Strengthened management and informationalization need to be developed to improve the level of rational drug use in the elderly.