老年住院患者临床用药分析

Clinical medication analysis of elderly hospitalized patients

目的评价老年住院患者的临床用药情况。方法用2019年版Beers标准评价我院老年住院患者潜在不适当用药(PIMs)情况,并用Logistic回归分析PIMs的相关因素。结果共纳入659例老年住院患者。经Beers标准检出541例(82.09%)老年患者存在PIMs。其中,老年人药物相关的PIMs涉及患者419例,老年人与疾病状态相关的PIMs涉及患者35例,老年人应谨慎使用的药物涉及患者428例,老年人应避免的药物间相互作用涉及患者31例,老年人基于肾功能应避免或减量使用的药物涉及患者45例。Logistic回归分析显示,年龄、住院期间用药数量和平均住院时间是老年患者PIMs独立危险因素(均P<0.05)。结论我院老年患者存在PIMs,临床药师需用评价工具发现PIMs,优化老年患者的药物治疗方案,促进合理用药。

Objective To evaluate the clinical medication status of the elderly hospitalized patients.Methods The Beers 2019 criteria were applied to evaluate potentially inappropriate medications(PIMs)among hospitalized patients.The associations between PIMs use and independent variables were analyzed by logistic regression.Results A total of 659 elderly patients were included in the study.541(82.09%)patients had at least one PIM identified by the Beers criteria,respectively.Among them,419 elder patients were involved in drug-related PIMs.35 elder patients were involved in PIMs related to disease status.428 elder patients were involved in drugs that should be used with caution.31 elder patients were involved in drug interactions that should be avoided.45 elder patients were involved in drugs that should be avoided or reduced based on renal function.Logistic regression analysis showed that age,number of drugs used during hospitalization and average length of stay were independent risk factors for PIMs in elderly patients(all P<0.05).Conclusion PIMs exist in elderly inpatients in our hospital.Clinical pharmacists need to use evaluation tools to find the PIMs,optimize drug treatment plans for elderly patients and promote rational drug use.