老年慢性病患者多重用药现状及处方干预研究

Study on current situation and prescription intervention of multiple medications in elderly chronic disease patients

目的分析泰州市第三人民医院老年慢性病患者多重用药现状以及处方干预研究的可行性。方法收集2021年1月-2022年12月于泰州市第三人民医院门诊就诊的310例老年慢性病患者作为观察对象。所患慢性病包括糖尿病、高血压、高脂血症、冠心病、慢性胃炎等;用药情况包括非胰岛素类降糖药、降压药、血脂调节药、抗血小板药物等。对患者慢性病与用药情况、用药依从性、对处方干预的态度等方面进行调查。结果310例患者中,患有慢性疾病数量为2-11种,平均每例患者患有慢性疾病(5.2±2.9)种。多重用药患者208例(67.10%),非多重用药患者102例(32.90%)。最常见的慢性疾病为高血压病(69.35%)。最常用的药物为钙通道阻滞药(69.68%)。共有78例患者(25.16%)用药完全依从,其余患者均存在一定用药依从性问题。其中最主要的问题为药物服用剂量不准确,共计212例(68.39%)。老年慢性病患者对于处方干预大多持支持的态度。结论老年慢性病患者多重用药的依从性较差,但是愿意接受处方干预,可以通过医生、药师、患者共同参与的模式开展处方干预,提高患者的用药依从性,以控制患者疾病进程,延长患者预期寿命,提高患者生活质量。

Objective To investigate the current situation of multiple medication use in elderly patients with chronic diseases in our hospital and the feasibility of prescription intervention research.Methods 310 elderly patients with chronic diseases who visited our outpatient department from January 2021 to December 2022 were collected.Chronic diseases include diabetes,hypertension,hyperlipidemia,coronary heart disease,chronic gastritis,etc.The medication situation includes non-insulin hypoglycemic drugs,antihypertensive drugs,blood lipid regulators,antiplatelet drugs,etc.Investigation on patients'chronic diseases and medication status,medication compliance,and attitudes towards prescription interventions was conducted.Results Among all 310 patients,the number of chronic diseases was 2-11,with an average of(5.2±2.9)chronic diseases per patient.There were 208 patients(67.10%)with multiple drug use,and 102 patients(32.90%)without multiple drug use.The most common chronic diseases are hypertension(69.35%),and the most commonly used drugs are calcium channel blockers(69.68%).A total of 78 cases(25.16%)had complete medication adherence,while the remaining patients had certain medication adherence issues.The main issue was inaccurate medication dosage,with a total of 212 cases(68.39%).Elderly patients with chronic diseases mainly have a supportive attitude towards prescription interventions.Conclusion Elderly patients with chronic diseases have poor compliance with multiple medications,but are willing to accept prescription intervention.Prescription intervention can be carried out through the participation of medical and nursing patients to improve their medication compliance,control the disease process,extend patient life expectancy,and improve patient quality of life.