基于2019年版Beers标准评价老年住院患者潜在不适当用药的价值

Evaluation of potential inappropriate medication for hospitalized elderly patients based on 2019 Beers criteria

目的基于Beers标准(2019年版)对老年住院患者潜在不适当用药(PIM)情况进行评价,为促进老年人临床合理用药提供参考。方法回顾性分析昆明医科大学附属延安医院2019年5月至11月出院的728例老年住院患者的用药情况。根据Beers标准(2019年版)对老年住院患者的PIM情况进行评估。采用SPSS 23.0统计软件进行数据分析。根据数据类型,分别采用t检验或χ^(2)检验进行组间比较。结果共纳入728例患者,其中存在≥1种PIM问题的患者308例,涉及的药物使用490次。490次PIM包括药物相关的PIM 256次(以苯二氮类、质子泵抑制剂最多);与疾病状态相关的PIM 10次;使用了老年患者应谨慎使用的药物176次;老年患者药物间的相互作用16次;使用了肾功能不全老年患者需谨慎使用的药物32次。结论基于2019年版Beers标准,该院老年患者的PIM涉及了所有评价内容,包括诸多临床应当关注和注意的问题,故该标准用于老年患者PIM的评价合理有效。

Objective To evaluate the potential inappropriate medication(PIM)for elderly inpatients based on the Beers criteria of 2019 edition in order to provide the references for rational clinical medication for the elderly.Methods A retrospective study was carried out on 728 elderly patients who were discharged from the Yan′an Hospital Affiliated to Kunming Medical University from May to November 2019.Their PIM status was assessed with 2019 Beers criteria.SPSS statistics 23.0 was used for data analysis.According to different data type,t test or χ^(2) test was used for data comparison between two groups.Results Among the 728 enrolled patients,308 of them had at least one type of PIM problems,involving a total of 490 times of drug use.Among the 490 times,256 times were drug-related PIM,with proton pump inhibitors and benzodiazepines most common.There were 10 times of PIM related to the disease state.There were 176 times of drugs that should be used with caution being used,and 16 drug interactions in these elderly patients.Thirty-two times of medications,which should be used with caution in elderly patients with renal insufficiency,were identified.Conclusion Our identified PIM problems in this study involve all evaluation contents in the 2019 Beers criteria and many clinical issues which deserve attention.Therefore,the criteria are reasonable and effective in the evaluation of PIM for elderly inpatients.