某基层医院老年多重用药住院患者潜在不适当用药评价

Evaluation of Potentially Inappropriate Medication in Elderly Inpatients with Polypharmacy in a Primary Hospital

目的:基于Beers标准评估某基层医院老年多重用药住院患者PIM发生情况,探究影响基层医院多重用药老年入院患者发生PIM的影响因素,加强老年患者的合理用药。方法:利用医院HIS系统以及合理用药系统回顾性分析某基层三甲医院2021年3月1日-2022年2月28日入院的老年多重用药患者用药情况,使用Beers标准评估其PIM发生情况,应用二元Logistic回归分析的方法确定主要影响因子。结果:共有6581例老年多重用药患者,其中4110例患者存在至少一种PIM情况,PIM发生率为62.5%(4110/6581)。在老年人发生潜在不适当用药中,地高辛、短效和中效作用的苯二氮䓬类的PIM发生率较高。单因素分析显示,药品数量、住院天数、住院总金额、药品金额以及罹患疾病数量与PIM有关(P<0.05)。Logistic回归分析显示,药品数量、药品金额以及罹患疾病数量是PIM的独立危险因素(P<0.05)。结论:某基层医院多重用药老年住院患者发生PIM情况普遍存在,并且药品数量、药品金额以及罹患疾病数量与老年患者PIM密切相关。

Objective:To evaluate the occurrence of PIM in elderly multi-drug inpatients in a primary hospitals based on Beers criteria,to explore the influencing factors of PIM in elderly inpatients with multi-drug in primary hospitals,and to strengthen rational drug use in elderly patients.Methods:The hospital HIS system and rational drug use system were used to retrospectively analyze the medication status of elderly patients with polypharmacy admitted to a tertiary hospital from March 1,2021 to February 28,2022.The Beers standard was used to evaluate the occurrence of PIM,and the binary Logistic regression analysis was used to determine the main influencing factors.Results:A total of 6581 patients met the inclusion criteria and did not meet the exclusion criteria,of which 4110 patients had at least one PIM condition,and the incidence of PIM was 62.5%(4110/6581).Among the potentially inappropriate medications in the elderly,digoxin,short-acting and intermediate-acting benzodiazepines had a higher incidence of PIM.Univariate analysis showed that there were statistically significant differences in the number of drugs,days of hospitalization,total hospitalization cost,drug cost,and number of diseases(P<0.05).Logistic regression analysis showed that the number of medicines,the cost of medicines and the number of diseases were independent risk factors for PIM(P<0.05).Conclusion:PIM is common in elderly inpatients with polypharmacy in a primary hospital,and the number of drugs,the amount of drugs and the number of diseases are closely related to PIM in elderly patients.