老年患者潜在不适当用药的影响因素分析

Analysis of influencing factors of potentially inappropriate medications used in elderly patients

目的探讨老年患者潜在不适当用药(PIM)的影响因素。方法回顾性分析2016年2月~2018年12月我院收治的420例老年患者的临床资料,收集所有患者的疾病诊断、用药情况及不良反应发生情况,统计不合理用药发生情况,进行多因素分析,并统计老年患者PIM的类型。结果420例老年患者中,共发生PIM187例,发生率为44.52%;PIM老年患者的性别、住院时间与未发生PIM者比较,差异无统计学意义(P>0.05);PIM老年患者的年龄、联合用药及查尔森合并症指数(CCI)评分与未发生PIM者比较,差异有统计学意义(P<0.05);经Logistic回归分析,年龄、联合用药及CCI评分是老年患者PIM发生的危险因素(OR>1,P<0.05);老年患者PIM以利尿剂、血管扩张剂为主,所占比例分别为48.13%、29.41%。结论年龄、联合用药及CCI评分是老年患者PIM发生的危险因素,应加强医生和药师对老年患者PIM筛查工作的宣传教育,适当减少联合用药。

Objective To explore the influencing factors of potential inappropriate medications(PIM)used in elderly patients.Methods The clinical data of 420 elderly patients who were treated in our hospital from February 2016 to December 2018 were retrospectively analyzed.The diagnosis,medication and adverse reactions of all patients were collected.The occurrence of irrational medication was analyzed using multivariate analysis.Types of PIM for elderly patients were extracted.Results Among 420 elderly patients,there were 187 cases with PIM accounting for 44.52%.There was no significant difference in the gender or hospitalization time compared with those without PIM(P>0.05).The age,joint medication,and Chalcson comorbidity index(CCI)score in the elderly PIM group were significantly different from those patients without PIM(P<0.05).Logistic analysis showed that age,joint medication and CCI score were risk factors for PIM in elderly patients(OR>1,P<0.05).PMI occurred in elderly patients were mainly diuretics and vasodilators,accounting for 48.13%and 29.41%,respectively.Conclusion Age,joint medication,and CCI score are risk factors for PIM in elderly patients.The publicity and education of PIM screening for elderly patients should be strengthened by doctors and pharmacists,and joint mediciation should be reduced in an appropriate way.