基于中国PIM标准分析老年精神疾病住院患者潜在不适当用药现状

Analysis of potentially inappropriate medication in elderly psychiatric inpatients based on criteria of potentially inappropriate medication for the elderly in China

目的调查分析老年精神疾病住院患者潜在不适当用药(PIM)现状。方法回顾分析2021年3月老年住院患者临床诊断、用药情况等资料,依据2017年版《中国老年人潜在不适当用药判断标准》分析处方PIM情况。结果125例研究对象中,平均年龄(73.31±7.87)岁,平均用药(6.62±2.68)种。101例(80.80%)患者存在140项PIM,81例(64.80%)患者使用了A级警示药物共103项,33例(40.74%)患者使用了B级警示药物共37项;高风险药物39项(27.86%),低风险药物101项(72.14%);PIM发生率排名前3位的药物是奥氮平、利培酮、劳拉西泮;12例患者存在4项与疾病状态相关的PIM。结论该院PIM发生率偏高,医生和药师应加大力度降低PIM比例,减少不良反应,提高用药安全,促进合理用药。

Objective To investigate the current status of potentially inappropriate medications(PIM) for elderly inpatients with mental illness in a psychiatric hospital.Methods Based on the 2017 edition of “Judgment Standards for Potentially Inappropriate Medications for the Elderly in China”, we retrospectively analyzed the PIM by investigating the clinical diagnosis and medication status of 125 elderly psychiatric inpatients in March 2021.Results Among 125 subjects, the average age was(73.31±7.87) years, and the average medication was(6.62±2.68). There were 101 patients(80.80%) had 140 items of PIM, 81 patients(64.80%) used a total of 103 items of A-level warning drugs, 33 patients(40.74%) used a total of 37 items of B-level warning drugs;there were 39 high-risk drugs(27.86%), 101 low-risk drugs(72.14%);the drugs with top three PIM incidence were olanzapine, risperidone and lorazepam;12 patients had 4 PIMs related to the disease state.Conclusions The incidence of PIM in this hospital is relatively high. Doctors and pharmacists should be advised to increase their efforts to reduce the proportion of PIM, reduce the incidence of adverse reactions, improve medication safety, and promote rational drug usage.