摘要
目的分析住院老年患者潜在不适当用药（PIM）现状及影响因素。方法收集2015年1至12月在合肥市第三人民医院内科住院、年龄≥65岁患者的病历资料，记录患者性别、年龄、住院科室、患病种数、住院天数、用药种数和付费方式等。将患者分为65-79岁组和≥80岁组，依据中国老年人PIM目录（中国目录），统计2组患者该目录中收录药物（PIM药物）使用率、使用PIM药物种数和PIM药物使用比例，采用Logistic回归方法分析PIM的影响因素。结果纳入分析患者共388例，男性206例，女性182例；年龄65-94岁，平均（76±7）岁；65-79岁组278例（71.6%），≥80岁组110例（28.4%）。全组患者PIM药物使用率为54.9%（213/388），高风险强度PIM药物使用率为28.6%（111/388）。65-79岁组PIM药物使用率为57.9%（161/278），≥80岁组为47.3%（52/110）（χ2=3.604，P=0.058）。使用PIM药物的213例患者中，使用1、2、3、4、5种药物者分别为132例（62.0%）、56例（26.3%）、17例（8.0%）、6例（2.8%）和2例（0.9%）。213例患者共使用了24种PIM药物，其中111例使用了17种高风险强度药物，分别占中国目录收录药物种数和高风险强度药物种数的33.3%（24/72）和48.6%（17/35）。使用率排在前3位的药物，65-79岁组依次为胰岛素、抗凝药、镇静催眠药，≥80岁组依次为抗凝药、镇静催眠药、茶碱。Logistic回归方法分析结果显示，PIM的主要影响因素为患者年龄（OR=0.531, 95%CI： 0.326-0.865, P=0.011）和用药种数（OR=3.927, 95%CI： 2.678-5.757, P〈0.001）结论老年患者的PIM药物使用率较高，影响PIM发生的因素为患者年龄和用药种数。
Objective To analyze the prevalence and risk factors of potentially inappropriate medication （PIM） use among elderly inpatients. Methods The data of patients ≥ 65 years of age and hospitalized in Department of Internal Medicine in the Third People＇s Hospital of Hefei from January to December in 2015 were collected and the gender, age, department, diseases that patient suffered from, hospitalization days, drug varieties used in one patient, methods of payment were recorded. The patients were divided into 2 groups： the 65-79 years old group and the 80 years old group. The utilization rate of PIM drugs, the drug varieties, the proportion of PIM use between the patients in the 2 groups were calculated. The risk factors of PIM use was analyzed by Logistic regression method. Results A total of 388 patients （their ages were from 65 to 79 years and their average age was （76 ± 7 ） years were enrolled in this study, including 206 males and 182 females. Of the 388 patients, 278 （71.6%） patients were in the 65-79 years old group and 110 （28.4%） were in the ≥80 years old group. The utilization rate of PIM drugs was 54.9% （213/388） and the utilization rate of high-risk PIM drugs was 28.6% （111/388）. The utilization rate of PIM drugs in the 65-79 years old group was 57.9% （161/278） and 47.3% （52/110） in the ≥80 years old group （χ2 = 3. 604, P = 0. 058）. Among 213 patients receiving PIM drugs, 132 （62.0%） patients were prescribed with one PIM drug, and 56 （26.3%）, 17 （8.0%）, 6 （2.8%）, 2（0.9% ） patients were prescribed with 2 to 5 PIM drugs, respectively. Twenty-four PIM drugs were used in the 213 patients and 17 high-risk PIM drugs were used in 111 patients, accounting for 33.3% （24/72） of the total number of PIM drugs and 48.6% （ 17/35 ） of the high-risk PIM drugs, respectively. According to the ratio of application, the top 3 drugs were insulin, anticoagulants, sedatives and hypnotics in the 65-79 years old group andanticoagulants, sedatives and hypnotics, and theophylline in the ≥ 80 years old group. The results of Logistic regression showed that the main risk factors of PIM use were ages （OR =0. 531, 95% CI： 0. 326- 0. 865, P = 0. 011 ） and prescribed drugs varieties （ OR = 3. 927, 95% CI： 2. 678-5. 757, P 〈 0. 001 ）. Conclusions The utilization rate of PIM drugs in elderly inpatients in our hospital was higher. The risk factors of PIM use were patients＇ages and drugs varieties.
出处
《药物不良反应杂志》
CSCD
2017年第1期17-21,共5页
Adverse Drug Reactions Journal
关键词
潜在不适当用药目录
老年人
Potentially inappropriate medication list
Aged
