北京多社区卫生服务中心老年患者处方降脂药物合理应用分析

Analysis of Rational Application of Lipid-lowering Drugs Prescribed by Elderly Patients in Beijing Multi-community Health Service Centers

目的分析社区老年高脂血症患者降脂药物处方情况,促进老年患者降脂药物合理应用。方法收集北京安贞医院医联体4家社区卫生服务中心2019年12月1~12日门诊就诊的老年患者处方各300张,分析不同社区不同种类降脂药物应用情况、降脂药物使用情况、联合用药情况。结果4家社区卫生服务中心1200份处方中258份为包含降脂药物的处方,其中大屯社区、金盏社区、潞城社区、甘棠社区中含降脂的药物处方分别有112例、66例、27例、53例。4家社区中应用最多的降脂药物均为他汀类,其次为胆固醇吸收抑制剂,其余种类的降脂药应用较少。降脂药物的联合应用处方共13例,两种他汀药物联合应用3例,联合应用种类共有5种,其中他汀类与胆固醇吸收抑制剂(依折麦布)的联合应用最多。不合理的降脂药物与非降脂药物联合用药情况中有1例辛伐他汀与红霉素联合应用,5例辛伐他汀与氨氯地平联合应用。结论4家社区卫生服务中心老年患者降脂药物总体应用合理,存在少数潜在不良反应风险的联合用药处方,临床需注意监测和随访。

Objective To analyze the prescription of lipid-lowering drugs in elderly patients with hyperlipidemia in the community,and promote the rational use of lipid-lowering drugs in elderly patients.Methods A collection of 300 prescriptions for elderly patients from the outpatient clinics of 4 community health service centers in Beijing Anzhen Hospital Medical Consortium from December 1 to 12,2019 were collected,and the application of different types of lipid-lowering drugs in different communities was analyzedcombination medication situation.Results Of the 1,200 prescriptions from 4 community health service centers,258 were prescriptions containing lipid-lowering drugs.Among them,there were 112 and 66 prescriptions for lipid-lowering drugs in Datun,Jinzhan,Lucheng,and Gantang communities,respectively,27 cases,53 cases.The most commonly used lipid-lowering drugs in the 4 communities are statins,followed by cholesterol absorption inhibitors,and the remaining types of lipid-lowering drugs are less used.There were 13 prescriptions for combined application of lipid-lowering drugs,3 cases of combined application of two statins,and 5 types of combined applications.Among them,the combination of statins and cholesterol absorption inhibitors(ezetimibe)was used the most.In the unreasonable combination of lipid-lowering drugs and non-lipid-lowering drugs,there was 1 case of simvastatin combined with erythromycin,and 5 cases of simvastatin combined with amlodipine.Conclusion The overall application of lipid-lowering drugs for elderly patients in the 4 community health service centers was reasonable,and there were a few combination prescriptions for potential adverse reactions.Clinical monitoring and follow-up were necessary.