老年慢性病患者用药偏差发生情况及其影响因素分析

Occurrence and influencing factors of medication deviation in elderly patients with chronic diseases

目的观察老年慢性病患者用药偏差发生情况,并分析导致其发生的相关因素。方法采用便利抽样法,选择2021年4月至2022年3月于医院接受治疗后出院的164例老年慢性病患者作为研究对象,药师对患者出院带药信息进行审核并统计用药偏差发生情况,将患者分为用药偏差发生组与未发生组,统计并比较两组患者及其主治医生相关资料,通过Logistic回归分析检验我院老年慢性病患者用药偏差发生的影响因素。结果164例患者中110例出现用药偏差,用药偏差发生率为67.1%,发生组患者所患疾病数量、出院时开具的药物品种较未发生组多(Z=2.552,t=3.063,均P<0.05);主治医生年龄、工作年限较未发生组短,职称较未发生组低(Z=3.754、3.713,Z=2.016,均P<0.05);Logistic回归分析显示,患者所患疾病数量及出院时开具的药物品种较多是我院老年慢性病患者用药偏差发生的危险因素(OR=1.260、1.227,均P<0.05);主治医生年龄较大、工作年限较长是我院老年慢性病患者用药偏差发生的保护因素(OR=0.925、0.930,均P<0.05)。结论老年慢性病患者用药偏差发生率较高,患者所患疾病数量及出院时开具的药物品种较多、主治医生年龄较小、工作年限较短均可能导致用药偏差情况的发生。

Objective To observe the occurrence of medication deviation in elderly patients with chronic diseases,and analyze the related factors leading to its occurrence.Methods Convenience sampling method was used to select 164 elderly patients with chronic diseases who were discharged from the hospital after treatment from April 2021 to March 2022 as the study subjects.The pharmacists reviewed the patient's discharge medication and counted the occurrence of medication deviation.The patients were divided into the occurrence group and the non-occurrence group,and the relevant data of the two groups and their attending physicians were analyzed and compared.Logistic regression analysis was used to test the influencing factors of medication deviation in elderly patients with chronic diseases.Results Medication deviation were identified in 110 of the 164 patients,and the incidence of medication deviation was 67.1%.Compared with the non-occurrence group,the number of diseases,discharge prescriptions of patients were more,the differences were statistically significant(Z=2.552,t=3.063,both P<0.05).The age of attending physicians in the occurrence group were younger,and their working years were shorter,professional title was lower compared with those in the non-occurrence group(Z=3.754,3.713,Z=2.016,P<0.05 for all);Logistic regression analysis showed that the number of diseases and discharge prescriptions were the risk factors for medication deviation in elderly patients with chronic diseases(OR=1.260,1.227,both P<0.05);older age and longer working years of attending physicians were the protective factors for medication deviation(OR=0.925,0.930,both P<0.05).Conclusions The incidence of medication deviation in elderly patients with chronic diseases in our hospital is high.Number of chronic diseases,discharge prescriptions,younger age and relatively shorter working years of attending physicians may lead to medication deviation.