接受家庭医疗护理的老年患者潜在不适当用药情况：一项回顾性数据分析
Potentially inappropriate medication use in elderly patients receiving home health care: a retrospective data analysis.
作者信息
Cannon Katrina T, Choi Maryann M, Zuniga Miguel A
机构信息
Department of Internal Medicine, Scott & White Hospital and Clinic and Health Sciences Center, The Texas A&M University System, Temple, USA.
出版信息
Am J Geriatr Pharmacother. 2006 Jun;4(2):134-43. doi: 10.1016/j.amjopharm.2006.06.010.
BACKGROUND
Previous medication management research has focused on hospital and long-term care facility settings, where drug-utilization reviews are used to reduce medication errors. Patients receiving home health care (HHC) are without the benefit of systematic drug-utilization reviews.
OBJECTIVE
The purpose of this study was to review medication use in elderly patients receiving HHC to identify the prevalence of potentially inappropriate medication (PIM) use, dangerous drug interactions (DDIs), and other patterns of medication use.
METHODS
This retrospective chart review was conducted using data from Medicare recipients aged > or =65 years who were patients of Scott & White Memorial Hospital and Clinic, Scott, Sherwood and Brindley Foundation, Temple, Texas, in 2002. Pharmacists compiled medication profiles based on admissions data. PIM use was identified using the Beers criteria. DDIs were identified using the Multidisciplinary Medication Management Project criteria. Polyphsarmsacy was identified in patients receiving > or =9 medications.
RESULTS
Data from 786 patients were included (mean [SD] age, 78 [7] years [range, 65-100 years; median, 78 years]; 36% men; 86% white; and 53% admitted to HHC after a hospital stay). The mean (SD) number of medications was 8.0 (3.7), with 39% of patients receiving polypharmacy. PIM use was identified in 31% of patients. DDIs were identified in 10% of patients, with a significantly higher prevalence in men (P < 0.01). Rates of PIM use and DDIs were 37% and 20%, respectively, in patients receiving polypharmacy.
CONCLUSION
In this retrospective data analysis in this population of elderly patients receiving HHC in 2002, PIM and DDI were prevalent, and polypharmacy was associated with increased rates of PIM use and DDIs.
背景
以往的药物管理研究主要集中在医院和长期护理机构，在这些地方，药物使用审查被用于减少用药错误。接受家庭健康护理（HHC）的患者无法受益于系统的药物使用审查。
目的
本研究的目的是回顾接受HHC的老年患者的用药情况，以确定潜在不适当用药（PIM）、危险药物相互作用（DDI）的发生率以及其他用药模式。
方法
本回顾性病历审查使用了2002年得克萨斯州坦普尔市斯科特与怀特纪念医院及诊所、斯科特、舍伍德和布林德利基金会中年龄≥65岁的医疗保险受益人的数据。药剂师根据入院数据编制用药档案。使用Beers标准确定PIM的使用情况。使用多学科药物管理项目标准确定DDI。在接受≥9种药物治疗的患者中确定多重用药情况。
结果
纳入了786例患者的数据（平均[标准差]年龄为78[7]岁[范围为65 - 100岁；中位数为78岁]；36%为男性；86%为白人；53%在住院后接受HHC）。平均（标准差）用药数量为8.0（3.7），39%的患者存在多重用药情况。31%的患者存在PIM使用情况。10%的患者存在DDI，男性的发生率显著更高（P < 0.01）。在多重用药的患者中，PIM使用和DDI的发生率分别为37%和20%。
结论
在对2002年接受HHC的老年患者群体进行的这项回顾性数据分析中，PIM和DDI很普遍，多重用药与PIM使用和DDI的发生率增加相关。
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