县级医院慢性病老年患者出院带药用药偏差现状及影响因素分析

Analysis on medication discrepancies and related factors at discharge with medicine in elderly patients with chronic diseases in county-level hospitals

目的:调查县级医院慢性病老年患者出院带药用药偏差现状并分析可能的原因及影响因素。方法:抽取江西省赣州市7家县级医院2020年1月1日至2020年12月31日60岁以上慢性病患者病例,评价其用药偏差发生的基本情况,采用Logistic回归模型分析用药偏差影响因素。结果:研究最终纳入693例患者,用药偏差总发生率为83.0%,平均每人发生2.1次用药偏差,发生用药偏差的类型主要为治疗不充分(60.6%);Logistic回归结果显示,发生用药偏差的患者合并症数量[(5.2±2.4)种]显著大于未发生用药偏差的患者[(3.9±2.0)种](P<0.01)。结论:样本县级医院慢性病老年患者出院带药用药偏差发生率较高,需在中国开展药物重整实证研究并对其实施效果进行评价。

OBJECTIVE To investigate the status quo and risk factors of medication discrepancies at discharge with medicine in elderly patients with chronic diseases in county-level hospitals.METHODS The study was conducted in 7 county-level hospitals in Ganzhou city.The records of elderly patients from January to December 2020 were selected.The status quo of medication discrepancies was evaluated by clinical pharmacists from a tertiary hospital.Multiple logistic regression was built to analyze the risk factors of medication discrepancies.RESULTS Totally 693 elderly patients were included in this study.A total of 83.0%patients experienced medication discrepancies,and each had 2.1 medication discrepancies on average.The most common type was inadequate treatment(60.6%).Multiple logistic regression showed that the complications(OR=0.777;95%CI 0.696-0.866;P<0.01)were associated with the medication discrepancies.CONCLUSION The incidence of medication discrepancies in elderly patients at discharge with medicine in the sample hospitals is relatively high,therefore,empirical research of medication reconciliation is needed and its effect needs to be evaluated in China.