基于不同标准老年住院患者潜在不适当用药评价与分析

Assessing Potentially Inappropriate Medications in Elderly Inpatients Based on Different Criteria

目的:基于Beers标准(2019版)和《中国老年人潜在不适当用药判断标准》(2017版)分析我院老年科住院患者潜在不适当用药情况,并对其影响因素进行分析。方法:回顾性收集我院2020年1-6月年龄≥65岁的老年科住院患者的相关信息,分别用上述两种标准分析老年患者潜在不适当用药情况。利用Logistics回归分析确定其影响因素,kappa检验进行一致性评价。结果:共纳入患者278例,平均年龄(77.14±8.61)岁,平均住院天数为(10.42±5.04)天。依据Beers标准,178例(64.03%)患者存在潜在不适当用药;依据《中国老年潜在不适当用药判断标准》161例(57.91%)患者存在潜在不适当用药。两种标准的一致性一般,用药种类是发生潜在不适当用药的危险因素。结论:老年科住院患者PIM发生率较高,两种标准在评估PIM中均有重要参考意义,在临床应用中,应结合两种标准给出用药建议,确保用药安全。

Objective:To analyze the potentially inappropriate medications(PIM)among elderly inpatients using the Beers criteria of 2019 and the criteria of PIMs for older adults in China(Chinese criteria),and to identify the correlates.Methods:The inpatients aged≥65 years at geriatrics of our hospital from January to June,2020 were included in this study.The Beers criteria of 2019 and the Chinese criteria were used to detect PIM.A multivariate logistic regression analysis was carried out to determine factors associated with the use of PIM.The concordance between the two criteria was calculated using kappa tests.Results:278 inpatients were included.The average age of the geriatric patients was(77.14±8.61)years,and the length of stay was(10.42±5.04)days.The prevalence of PIM was 64.03%and 57.91%according to 2019 Beers criteria and the Chinese criteria,respectively.The two criteria indicated a moderate coherence.The factor associated with PIM by both criteria was the number of prescribed medications.Conclusion:Data showed a high PIM prevalence among the elderly inpatients.Two criterions both play a critical role in evaluating PIMs.In clinical applications,medication recommendations should be combined with the two criterions to ensure medication safety.