Nomoto Shinichi, Nakanishi Yuka
Department of Human Health Sciences, Kyoto University Graduate School of Medicine.
Nihon Ronen Igakkai Zasshi. 2011;48(3):276-81. doi: 10.3143/geriatrics.48.276.
background & aim: Elderly patients often suffer comorbidity, which leads to polypharmacy (≥ 6 concurrent medications). The extent of polypharmacy in very elderly patients in university hospitals has been reported, but not in community hospital outpatient units. We investigated polypharmacy in late-stage elderly patients at an outpatient unit of a community hospital.
The study group comprised 159 patients who visited a community hospital during 6 consecutive days. We analyzed the number of consultations and the changeless prescriptions for the past three months or more in the medical records of these patients.
Patients took up to 15 types of medication (average 6.5 ± 3.5) and up to 36 tablets (average 12.4 ± 7.8 tablets/day) at the time of survey. Over 9 months, 76.1% of patients had multiple consultations. A total of 57.9% of patients received polypharmacy. Antihypertensive drugs were prescribed to 20.3% of patients. Inappropriate prescription accounted for 4.8% of a total of 1,031 prescriptions.
A larger number of very elderly patients was receiving polypharmacy and multiple consultations in outpatient units of a community hospital than has been previously reported in university hospitals. It is important to prescribe appropriately for very elderly patients in teams which include pharmacists and nurses as well as doctors.
背景与目的：老年患者常患多种合并症，这导致了多药联用（同时服用≥6种药物）。大学医院中高龄患者的多药联用情况已有报道，但社区医院门诊科室的情况尚未见报道。我们调查了一家社区医院门诊科室中晚期老年患者的多药联用情况。
研究组包括连续6天到社区医院就诊的159例患者。我们分析了这些患者病历中过去三个月或更长时间的会诊次数和无变化的处方。
调查时患者服用的药物种类多达15种（平均6.5±3.5种），片剂多达36片（平均每天12.4±7.8片）。在9个月的时间里，76.1%的患者进行了多次会诊。共有57.9%的患者接受了多药联用治疗。20.3%的患者开具了抗高血压药物。在总共1031张处方中，不适当处方占4.8%。
与大学医院之前报道的情况相比，社区医院门诊科室中接受多药联用治疗和多次会诊的高龄患者数量更多。在包括药剂师、护士和医生的团队中为高龄患者合理开药很重要。
