Institute of Clinical Pharmacology and Toxicology, Charité, Universitätsmedizin Berlin, Berlin, Germany.
Pharmacoepidemiol Drug Saf. 2011 Jan;20(1):12-9. doi: 10.1002/pds.2005.
The current use of inappropriate medication in elderly nursing home residents (NHRs) in Germany is unclear. We therefore set out to analyse the frequency and patterns of potentially inappropriate drug prescriptions in elderly NHRs in Germany.
We utilised prescription data for NHRs 65 years or older from a large German health insurance company during a period of 3 months. Inappropriate drugs were identified from a recently reported French consensus list.
Data for 7271 (83.7%) females and 1414 (16.3%) males were available for analysis. The average age was 83.6 ± 7.3 years. Overall 48 inappropriate drugs were prescribed resulting in a total of 3825 inappropriate drug prescriptions which accounted for 4.3% of all documented prescriptions (n = 88,695). One thousand nine hundred and three (21.9%) residents received at least one inappropriate drug prescription. Using logistic regression we detected no significant influence of gender or level of care on frequency of inappropriate prescriptions. However, age had a significant influence; with increasing age the frequency of residents receiving inappropriate medications decreased steadily (r = -0.92, p = 0.003) and ranged from a maximum of 32.8% in the group between 65 and 69 years to a minimum of 15.2% in residents older than 94 years. This observation was paralleled by a significant and continuous decrease of drug prescription rates with increasing age (r = -0.88, p = 0.009).
The present analysis demonstrates that about one out of five elderly NHRs received at least one inappropriate drug prescription. Additional studies may aim to establish a list of frequently prescribed inappropriate drugs for Germany.
目前，德国养老院老年人（NHR）中存在不适当用药的情况尚不清楚。因此，我们旨在分析德国老年 NHR 中潜在不适当药物处方的频率和模式。
我们利用一家大型德国健康保险公司在 3 个月期间为 65 岁或以上的 NHR 提供的处方数据。从最近报道的法国共识清单中确定不适当的药物。
共分析了 7271 名（83.7%）女性和 1414 名（16.3%）男性的数据。平均年龄为 83.6 ± 7.3 岁。共有 48 种不适当的药物被开处方，总计开具了 3825 种不适当的药物处方，占所有记录处方（n = 88695）的 4.3%。有 1930 名（21.9%）居民至少接受了一种不适当的药物处方。使用逻辑回归，我们未发现性别或护理水平对不适当处方频率有显著影响。然而，年龄有显著影响；随着年龄的增长，接受不适当药物治疗的居民的频率稳步下降（r = -0.92，p = 0.003），范围从 65 至 69 岁组的 32.8%最高到 94 岁以上居民的 15.2%最低。这一观察结果与随着年龄的增长，药物处方率呈显著和连续下降的趋势相吻合（r = -0.88，p = 0.009）。
本分析表明，约五分之一的老年 NHR 至少接受了一种不适当的药物处方。进一步的研究可能旨在为德国制定一份经常开处方的不适当药物清单。
