尼泊尔西部一所教学医院老年住院患者的药物使用情况。

Drug utilisation among older inpatients in a teaching hospital in Western Nepal.

机构信息

Department of Pharmacology, Manipal College of Medical Sciences, PO Box 155, Deep Heights, Pokhara, Nepal.

出版信息

Singapore Med J. 2010 Jan;51(1):28-34.

PMID:20200772

Abstract

INTRODUCTION

The proportion of the elderly population in Nepal, though low, is steadily increasing. Studies on drug utilisation among geriatric patients in Western Nepal, a region with the highest proportion of the elderly in all of Nepal, are lacking. The present study was carried out at the Manipal Teaching Hospital, a 700-bed teaching hospital in Pokhara, Western Nepal.

METHODS

The study was carried out from June 1, 2005 to May 31, 2006 using case records of discharged patients aged 60 years and older. This was an observational study that utilised a retrospective case notes review methodology. The microorganisms isolated on culture and their antibiotic sensitivity patterns were studied. Drug consumption was measured by the defined daily dose (DDD) per 100 bed-days. The mean cost of the drugs was calculated. The percentage of drugs prescribed by generic name and the percentages of fixed-dose combinations used were noted. The basic demographic information of older inpatients, drug utilisation patterns, drug consumption using DDD, organisms isolated and their antibiotic sensitivity patterns, and the mean cost of the drugs were studied.

RESULTS

A total of 548 patients were admitted. Hypertension, acute exacerbation of chronic obstructive pulmonary disease and cancer were the most common illnesses among the patients. The mean number of drugs consumed by each patient was 7.73. Escherichia coli and Pseudomonas aeruginosa were the most common microorganisms isolated. Ranitidine, multivitamins, amlodipine, ipratropium and dextrose normal saline were most commonly prescribed. The DDD per 100 bed-days of ranitidine and omeprazole (highest values) was 33.48 and 3.51, respectively. The mean cost of drugs was USD26.6, and antibiotics accounted for around 40 percent of the cost.

CONCLUSION

The use of a high number of drugs, and of parenteral drugs and intravenous fluids, is a common problem. The prescription of generic drugs is low. Guidelines for the use of drugs in the elderly are required and further studies are needed on this issue.

摘要

简介

尼泊尔的老年人口比例虽然较低，但在稳步增加。然而，在尼泊尔西部，这个老年人口比例最高的地区，缺乏针对老年患者药物使用情况的研究。本研究在尼泊尔西部博克拉的一家 700 床位的教学医院——曼尼帕尔教学医院进行。

方法

本研究于 2005 年 6 月 1 日至 2006 年 5 月 31 日期间，使用年龄在 60 岁及以上出院患者的病历进行。这是一项观察性研究，采用回顾性病历回顾方法。研究了培养物中分离出的微生物及其抗生素敏感性模式。通过每 100 个床位日的限定日剂量 (DDD) 来衡量药物的消耗。计算药物的平均费用。记录按通用名开处方的药物比例和使用固定剂量组合的百分比。研究了老年住院患者的基本人口统计学信息、药物使用模式、使用 DDD 的药物消耗、分离出的微生物及其抗生素敏感性模式以及药物的平均费用。

结果

共有 548 名患者入院。高血压、慢性阻塞性肺疾病急性加重和癌症是患者中最常见的疾病。每位患者平均使用 7.73 种药物。大肠埃希菌和铜绿假单胞菌是最常见的分离微生物。雷尼替丁、多种维生素、氨氯地平、异丙托溴铵和葡萄糖生理盐水是最常开的药物。每 100 个床位日的雷尼替丁和奥美拉唑的 DDD（最高值）分别为 33.48 和 3.51。药物的平均费用为 26.6 美元，抗生素约占费用的 40%。