Niwata Satoko, Yamada Yukari, Ikegami Naoki
Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan.
BMC Geriatr. 2006 Jan 11;6:1. doi: 10.1186/1471-2318-6-1.
The prevalence and risk factors of potentially inappropriate medication use among the elderly patients have been studied in various countries, but because of the difficulty of obtaining data on patient characteristics and medications they have not been studied in Japan.
We conducted a retrospective cross-sectional study in 17 Japanese long-term care (LTC) facilities by collecting data from the comprehensive MDS assessment forms for 1669 patients aged 65 years and over who were assessed between January and July of 2002. Potentially inappropriate medications were identified on the basis of the 2003 Beers criteria.
The patients in the sample were similar in terms of demographic characteristics to those in the national survey. Our study revealed that 356 (21.1%) of the patients were treated with potentially inappropriate medication independent of disease or condition. The most commonly inappropriately prescribed medication was ticlopidine, which had been prescribed for 107 patients (6.3%). There were 300 (18.0%) patients treated with at least 1 inappropriate medication dependent on the disease or condition. The highest prevalence of inappropriate medication use dependent on the disease or condition was found in patients with chronic constipation. Multiple logistic regression analysis revealed psychotropic drug use (OR = 1.511), medication cost of per day (OR = 1.173), number of medications (OR = 1.140), and age (OR = 0.981) as factors related to inappropriate medication use independent of disease or condition. Neither patient characteristics nor facility characteristics emerged as predictors of inappropriate prescription.
The prevalence and predictors of inappropriate medication use in Japanese LTC facilities were similar to those in other countries.
各国已对老年患者中潜在不适当用药的患病率及风险因素展开研究，但由于获取患者特征和用药数据存在困难，日本尚未进行此类研究。
我们对17家日本长期护理（LTC）机构进行了一项回顾性横断面研究，收集了2002年1月至7月期间接受评估的1669名65岁及以上患者的综合MDS评估表数据。根据2003年Beers标准确定潜在不适当用药。
样本中的患者在人口统计学特征方面与全国调查中的患者相似。我们的研究表明，356名（21.1%）患者接受了与疾病或病情无关的潜在不适当用药治疗。最常被不适当处方的药物是噻氯匹定，有107名患者（6.3%）使用了该药。300名（18.0%）患者接受了至少一种与疾病或病情相关的不适当用药治疗。与疾病或病情相关的不适当用药使用患病率最高的是慢性便秘患者。多因素逻辑回归分析显示，使用精神药物（比值比=1.511）、每日用药费用（比值比=1.173）、用药数量（比值比=1.140）和年龄（比值比=0.981）是与不考虑疾病或病情的不适当用药相关的因素。患者特征和机构特征均未成为不适当处方的预测因素。
日本长期护理机构中不适当用药的患病率及预测因素与其他国家相似。
