两种标准评价老年住院患者的潜在不适当用药结果及影响因素分析

Two standards analysis of potential inappropriate medication in elderly inpatients

目的:采用2019年版B e e r s标准(以下简称B e e r s标准)和2017年版《中国老年人潜在不适当用药判断标准》(简称中国标准)分析我院老年住院患者潜在不适当用药(P I M)的情况。方法:选取2021年6月—12月宜宾市第一人民医院收治的年龄≥65岁的4635例住院患者。收集患者的年龄、性别、诊断、医嘱、住院天数、药品费用、总医疗费用等基本信息,分别采用Beers标准和中国标准审查老年住院患者PIM情况,并应用二元Logistic回归分析PIM发生的相关危险因素。结果:Beers标准筛选出PIM占比为62.55%(2899例);中国标准筛选出PIM占比为67.62%(3134例),两组差异显著(P<0.05)。L o g i s t i c结果显示,诊断种数、用药种类是P I M发生的危险因素(P<0.05)。结论:多重用药和PIM在老年患者发生率很高,多重药物是PIM发生最相关的独立危险因素。药师应协助临床促进老年患者的合理用药,降低PIM的发生率。

Objective The 2019 edition of beers standard and the 2017 edition of the judgment standards for potentially inappropriate medication in the elderly in China(as Chinese standard)were used to analyze the occurrence of potential inappropriate medication(PIM)in elderly hospitalized patients in our hospital.Methods A total of 4635 inpatients aged≥65 years admitted to Yibin First People’s Hospital from June to December 2021 were enrolled.The basic information of patients,such as age,gender,diagnosis,medical advice,length of hospitalization,drug cost,and total medical cost,was collected,and the incidence of PIM in elderly hospitalized patients was reviewed using the beers standard and the Chinese standard,and the relevant risk factors for PIM occurrence were analyzed by binary logistic regression.Results The proportion of PIM screened by the beers standard was 62.55%(2899 cases).The proportion of PIM screened in the Chinese standard was 67.62%(3134 cases).Two standards were significant difference(P<0.05).The logistic results showed that the number of diagnosed species and drug type were risk factors for the occurrence of PIM(P rarely 0.05).Conclusion The incidence of polypharmacy and PIMs is high in elderly patients,and polypharmacy is the most relevant independent risk factor for the occurrence of PIM.Pharmacists should help clinically promote the rational use of drugs in elderly patients and reduce the incidence of PIM.