Vlahović-Palcevski Vera, Bergman Ulf
Unit of Clinical Pharmacology, University Hospital Centre Rijeka, University of Rijeka Medical School, Kresimirova 42, 51000 Rijeka, Croatia.
Eur J Clin Pharmacol. 2004 May;60(3):217-20. doi: 10.1007/s00228-004-0747-y. Epub 2004 Apr 7.
The quality of medication use by the elderly is a major safety concern because of an increasing number of people in this segment of the population and the fact that they are major drug consumers. The objective of this study was to test whether administrative computerized pharmacy prescription data could be used to assess the prevalence of potentially inappropriate medication use by the elderly in Rijeka, Croatia, using two sets of explicit criteria data.
In 2002, the prevalence of potentially inappropriate medication use in the elderly aged 70 years or over was evaluated using Beers' criteria. Inappropriate co-prescribing was evaluated using a list of eight potentially harmful drug combinations. Information on the use of drugs was collected from a computerized pharmacy record of all prescriptions dispensed in the "Jadran Pharmacies" in Rijeka.
Five computerized pharmacies dispensed 306,000 (65% of all prescriptions in Rijeka); 78,000 were for those aged 70 years and over. Among these elderly, the prevalence of inappropriate choice of drugs was 2.2% and inadequate co-prescribing 1.9%. The most common inappropriate drug was a long-acting benzodiazepine, diazepam. Mostly used potentially harmful combinations were a non-steroidal anti-inflammatory drug (NSAID) co-prescribed with a diuretic, and two benzodiazepines co-prescribed.
We found that computerized pharmacy data can be used as a screening tool in efforts to improve the quality of drug prescribing in Rijeka. Explicit criteria for assessing inappropriate prescribing for the elderly can easily be applied to population based surveys. This study suggests a low rate of potentially inappropriate prescribing for the elderly in Rijeka.
由于老年人口数量不断增加且他们是主要的药物消费者，老年人用药质量是一个主要的安全问题。本研究的目的是使用两组明确的标准数据，测试行政计算机化药房处方数据是否可用于评估克罗地亚里耶卡市老年人潜在不适当用药的患病率。
2002年，使用Beers标准评估70岁及以上老年人潜在不适当用药的患病率。使用一份包含八种潜在有害药物组合的清单评估不适当的联合用药情况。药物使用信息从里耶卡市“亚得兰药房”所有配发处方的计算机化药房记录中收集。
五家计算机化药房配发了306,000张处方（占里耶卡市所有处方的65%）；其中78,000张是为70岁及以上的人开具的。在这些老年人中，药物选择不当的患病率为2.2%，联合用药不当的患病率为1.9%。最常见的不当药物是长效苯二氮䓬类药物地西泮。最常使用的潜在有害组合是一种非甾体抗炎药（NSAID）与一种利尿剂联合使用，以及两种苯二氮䓬类药物联合使用。
我们发现计算机化药房数据可作为一种筛选工具，用于努力提高里耶卡市的药物处方质量。评估老年人不当处方的明确标准可轻松应用于基于人群的调查。本研究表明里耶卡市老年人潜在不当处方的发生率较低。
