意大利七家医院老年住院患者的用药模式：评估老年复杂患者合理用药标准（CRIME）项目的结果

Pattern of medication use among older inpatients in seven hospitals in Italy: results from the CRiteria to assess Appropriate Medication use among Elderly complex patients (CRIME) project.

作者信息

Tosato Matteo, Settanni Silvana, Antocicco Manuela, Battaglia Miriam, Corsonello Andrea, Ruggiero Carmelinda, Volpato Stefano, Fabbietti Paolo, Lattanzio Fabrizia, Bernabei Roberto, Onder Graziano

机构信息

Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.

出版信息

Curr Drug Saf. 2013 Apr;8(2):98-103. doi: 10.2174/1574886311308020002.

DOI:10.2174/1574886311308020002

PMID:23713540

Abstract

BACKGROUND

Prescribing pharmacological treatment for hospitalized older patients represents a challenge for physicians. In particular, hospitalized older adults present with acute and chronic diseases, which may require multiple treatments and increase their susceptibility to adverse drug reactions. Patterns of drugs use have rarely been investigated in these patients.

OBJECTIVE

To describe patterns of drugs use among hospitalized older adults participating in the CRiteria to assess Appropriate Medication use among Elderly complex patients (CRIME) project.

METHODS

We performed a cross-sectional multicentre study based on data from the CRIME project, a study performed in geriatric and internal medicine acute care wards of 7 Italian hospitals. The only two exclusion criteria were: age < 65 years old and unwillingness to participate in the study. Participants were assessed at hospital admission and followed until discharge.

RESULTS

Mean (Standard Deviation) age of 1123 participants was 81.5 (7.4) years, with 629 (56%) being women and 572 participants (51%) were admitted from Emergency Room. Mean length of stay was 11.2 (6.7) days. Mean number of drugs used greatly varied before (6.2, SD 3.2), during (10.6, SD 5.6) and after (7.1, SD 3.1) hospitalization. No difference in the number of drugs used during hospital stay was observed across age groups. During hospital stay, drugs for acid related disorders (77.9%) and antithrombotic agents (76.8%) were the most commonly used drugs, followed by drugs acting on the renin-angiotensin system (58.0%) and diuretics (57.1%). Very common was the use of psycholeptics (34.3%) and psychoanaleptics (22.4%).

CONCLUSION

Use of multiple drug treatments is common in hospitalized older adults and hospitalization is associated with a substantial increment in the number of drugs used, with no differences across age groups.

摘要

背景

为住院老年患者开具药物治疗方案对医生来说是一项挑战。特别是，住院老年患者患有急性和慢性疾病，可能需要多种治疗，这增加了他们发生药物不良反应的易感性。这些患者的用药模式很少被研究。

目的

描述参与评估老年复杂患者合理用药标准（CRIME）项目的住院老年患者的用药模式。

方法

我们基于CRIME项目的数据进行了一项横断面多中心研究，该项目在意大利7家医院的老年医学和内科急性护理病房开展。仅有的两项排除标准是：年龄<65岁和不愿参与研究。参与者在入院时接受评估，并随访至出院。

结果

1123名参与者的平均（标准差）年龄为81.5（7.4）岁，其中629名（56%）为女性，572名参与者（51%）从急诊室入院。平均住院时间为11.2（6.7）天。住院前（6.2，标准差3.2）、住院期间（10.6，标准差5.6）和住院后（7.1，标准差3.1）使用的药物平均数量差异很大。各年龄组住院期间使用的药物数量没有差异。住院期间，治疗酸相关疾病的药物（77.9%）和抗血栓药物（76.8%）是最常用的药物，其次是作用于肾素-血管紧张素系统的药物（58.0%）和利尿剂（57.1%）。使用抗精神病药物（34.3%）和精神振奋药（22.4%）的情况非常普遍。