Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France.
J Am Med Dir Assoc. 2013 Apr;14(4):265-9. doi: 10.1016/j.jamda.2012.10.018. Epub 2012 Dec 1.
Very scarce information is available about the use of proton-pump inhibitors (PPI) in nursing homes (NH). This study investigated the factors associated with PPI use among NH residents.
Cross-sectional
One hundred seventy-five NHs in Midi-Pyrénées region, South-Western France.
Data was collected for 6275 NH residents. Participants (73.7% women) were aged 86 years (± 8.2).
NH staff sent participants' drug prescriptions to research team; they also recorded information on residents' health characteristics. A binary logistic regression was performed on PPI use.
PPI use was highly prevalent (n = 2 370, ie, 37.8%). Whilst peptic ulcer (OR 4.741; 95% CI 3.647-6.163) and nonsteroidal anti-inflammatory drugs (OR 2.124; 95% CI 1.528-2.951) were important indicators of PPI use, they explained just a small fraction of PPI prescriptions; most prescriptions were probably inappropriately related to a general condition of health vulnerability, reflected by polypharmacy and comorbidities.
Vulnerable people take PPIs more often in NHs. Physicians must be aware about the health risks possibly induced by inappropriate PPI use when prescribing these drugs for NH residents.
关于质子泵抑制剂(PPI)在养老院(NH)中的使用,相关信息非常有限。本研究调查了与 NH 居民中 PPI 使用相关的因素。
横断面研究
法国西南部米迪-庇里牛斯地区的 175 家 NH。
收集了 6275 名 NH 居民的数据。参与者(73.7%为女性)年龄为 86 岁(±8.2)。
NH 工作人员将参与者的药物处方发送给研究团队;他们还记录了居民健康特征的信息。对 PPI 使用情况进行了二元逻辑回归分析。
PPI 的使用率非常高(n=2370,即 37.8%)。虽然消化性溃疡(OR 4.741;95% CI 3.647-6.163)和非甾体抗炎药(OR 2.124;95% CI 1.528-2.951)是 PPI 使用的重要指标,但它们仅解释了一小部分 PPI 处方;大多数处方可能与一般健康脆弱性有关,这反映在多药治疗和合并症方面。
在 NH 中,弱势人群更常服用 PPI。当为 NH 居民开这些药物时,医生必须意识到不适当使用 PPI 可能带来的健康风险。