某三甲医院老年住院患者潜在不适当处方横断面调查

A cross-sectional investigation of potential inappropriate prescriptions for elderly inpatients in a third class hospital

目的回顾性调查老年住院患者潜在不适当处方(PIP)现况。方法2020年10月—2021年3月,简单随机抽样上海交通大学医学院附属第九人民医院老年住院患者的病历资料,以2023版STOPP/START标准为依据,对患者潜在不适当用药(PIM)和潜在遗漏用药(PPO)的发生情况进行调查。结果共纳入391例患者,136例(34.78%)患者出现PIM事件,共185次;135例(34.53%)出现PPO事件,共185次。根据STOPP标准,主要的PIM种类为缺乏循证临床适应证的药物处方(27次)、非甾体类抗炎药(25次)和抗精神病药(17次);根据START标准,主要的PPO种类为使用非甾体类抗炎药时使用质子泵抑制剂(52次)、有症状的冠状动脉疾病患者使用β受体阻滞剂(20次)和钠--葡萄糖耦联转运体抑制剂治疗症状性心力衰竭(20次)。结论老年住院患者PIP发生率可能较高。

Objective To investigate the current situation of potential inappropriate prescription(PIP)for elderly inpatients retrospectively.Methods From October 2020 to March 2021,a simple random sampling method was used to select the medical records of elderly inpatients in Ninth People s Hospital Affiliated to Medical College of Shanghai Jiaotong University.According to the 2023 version of STOPP/START standard,the occurrence of potential inappropriate medication(PIM)and potential prescribing omission(PPO)was investigated.Results A total of 391 patients were included in this study.136(34.78%)patients had PIM events,a total of 185 cases;135(34.53%)patients had PPO events,a total of 185 cases.According to STOPP criteria,the main types of PIM were drug prescriptions lacking evidence-based clinical indications(27 cases),non-steroidal anti-inflammatory drugs(25 cases)and antipsychotics(17 cases).According to START criteria,the main types of PPO were proton pump inhibitors used in combination with non-steroidal anti-inflammatory drugs(52 cases),beta-blockers used in patients with symptomatic coronary artery disease(20 cases),and sodium-glucose linked transporter 2 inhibitors used in patients with symptomatic heart failure(20 cases).Conclusion The incidence of PIP is high in elderly inpatients.