Alonso Martínez J L, Abínzano Guillén M L, Elejalde Guerra J I, Rubio Vela T, García Labairu C, Andériz López M
Servicio de Medicina Interna, Hospital de Navarra, Pamplona.
An Med Interna. 1999 Jan;16(1):25-30.
The amount and quality of drugs prescribed after hospitalization in Internal Medicine and the factors which influence them have been rarely evaluated in Spain.
We study prospectively drugs prescribed in patients hospitalized in Internal Medicine analyzing amount of drugs before admission (BAD), on discharge (DD), end drugs after temporal drugs were removed (ED), drugs prescribed as chronic treatment (CTD), symptomatic drugs (SD), acute-use drugs (AUD) and low therapeutic utility drugs (LTUD). We also evaluated the sort of drugs and the factors implicated in increase or decrease of prescription volume.
Two hundred and eighty-five patients were evaluated [164 males, 121 females, mean age 68.08 (SD 15.27)]. They had mean BAD 3.42(SD 2.67)7 DD 3.92 (SD 2.36) (p < 0.001) and ED 3.65 (SD 2.30) (No differences with BAD). The amount of drugs were higher in patients 65 years old and elder (p < 0.001). LTUD were decreased from 62(22%) patients on admission to 21 (7%) on discharge (p < 0.001). Compounded drugs were reduced from 36 (13%) patients to 17 (6%) (p < 0.05). Age older 65, length of stay greater 7 days, need for intravenous administration of drugs, comorbidities and complications during hospitalization all caused increase in prescription volume on discharge. Logistic-regression analysis showed that CTD and AUD were the main causes of increase of drugs while BAD and LTUD were protective. Drugs reduced in higher proportion were mucolytics (p < 0.005) drugs to treat plant-based hyperplasia benign of prostate (p < 0.05), brain vasodilators (p < 0.001) and peripheral vasodilators (p < 0.01).
Hospitalization in Internal Medicine results in an increase of prescription volume though it is short-term. The higher number of drugs is accumulated in elderly. Factors implicated in increasing are length of stay, need for intravascular access, complications during inpatient, drugs to treat acute diseases and chronic use drugs. Low therapeutic utility drugs are used before admission in outpatients.
在西班牙，很少有人对内科学住院后所开药物的数量和质量及其影响因素进行评估。
我们前瞻性地研究了内科住院患者所开的药物，分析了入院前（BAD）、出院时（DD）、去除临时用药后的最终用药量（ED）、作为慢性治疗的药物（CTD）、对症药物（SD）、急性用药（AUD）和低治疗效用药物（LTUD）。我们还评估了药物种类以及与处方量增加或减少相关的因素。
共评估了285例患者[男性164例，女性121例，平均年龄68.08（标准差15.27）]。他们的平均BAD为3.42（标准差2.67），DD为3.92（标准差2.36）（p<0.001），ED为3.65（标准差2.30）（与BAD无差异）。65岁及以上患者的药物数量更多（p<0.001）。LTUD从入院时的62例（22%）降至出院时的21例（7%）（p<0.001）。复方制剂从36例（13%）患者降至17例（6%）（p<0.05）。65岁以上、住院时间超过7天、需要静脉用药、住院期间的合并症和并发症均导致出院时处方量增加。逻辑回归分析表明，CTD和AUD是药物增加的主要原因，而BAD和LTUD具有保护作用。比例下降较高的药物有黏液溶解剂（p<0.005）、治疗前列腺良性增生的药物（p<0.05）、脑血管扩张剂（p<0.001）和外周血管扩张剂（p<0.01）。
内科住院导致处方量增加，尽管是短期的。老年人积累的药物数量更多。与增加相关的因素有住院时间、血管通路需求、住院期间的并发症、治疗急性疾病的药物和慢性用药。低治疗效用药物在门诊患者入院前使用。
