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老年人潜在不适当用药情况:基于人群估计的不同明确标准的全国性比较。

Potentially inappropriate drug use in older people: a nationwide comparison of different explicit criteria for population-based estimates.

作者信息

Morin Lucas, Fastbom Johan, Laroche Marie-Laure, Johnell Kristina

机构信息

Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.

Centre Hospitalier Universitaire de Limoges, Service de Pharmacologie, Toxicologie et Pharmacovigilance, Limoges, France.

出版信息

Br J Clin Pharmacol. 2015 Aug;80(2):315-24. doi: 10.1111/bcp.12615. Epub 2015 May 26.

Abstract

AIMS

The aim was to investigate the prevalence of potentially inappropriate medication use among older people in Sweden according to five different published sets of explicit criteria from Europe and the US.

METHODS

This was a nationwide cross-sectional, register-based study across the whole of Sweden in 2008. All individuals aged 65 years and older were included (n = 1 346 709, both community-dwelling and institutionalized persons). We applied all drug-specific criteria included in the 2012 Beers Criteria, the Laroche's list, the PRISCUS list, the NORGEP criteria and the Swedish National Board of Health and Welfare criteria. The main outcome was the potentially inappropriate drug use according to each set of criteria, separately and combined. Multivariate logistic regression models were used to identify individual factors associated with the use of potentially inappropriate drugs.

RESULTS

The prevalence of potentially inappropriate medication use varied between the explicit criteria from 16% (NORGEP criteria) to 24% (2012 Beers criteria). Overall, 38% of the older people were exposed to potentially inappropriate drug use by at least one of the five sets of criteria. While controlling for other possible covariates, female gender, institutionalization and polypharmacy were systematically associated with inappropriate drug use, regardless of the set of explicit criteria we considered.

CONCLUSION

Although explicit criteria for inappropriate drug use among older people have been reported to be quite different in their content, they provide similar measures of the prevalence of potentially inappropriate drug use at the population level.

摘要

目的

根据欧洲和美国已发表的五套不同明确标准,调查瑞典老年人中潜在不适当用药的患病率。

方法

这是一项基于全国登记数据的横断面研究,于2008年在瑞典全境开展。纳入所有65岁及以上的个体(n = 1346709,包括社区居住者和机构居住者)。我们应用了2012年版《Beers标准》、拉罗什清单、PRISCUS清单、挪威老年药物处方筛选标准(NORGEP标准)以及瑞典国家卫生和福利委员会标准中包含的所有药物特定标准。主要结局是根据每套标准单独及综合判断的潜在不适当用药情况。采用多变量逻辑回归模型确定与使用潜在不适当药物相关的个体因素。

结果

根据不同明确标准,潜在不适当用药的患病率在16%(NORGEP标准)至24%(2012年版《Beers标准》)之间。总体而言,38%的老年人至少符合五套标准中的一套所定义的潜在不适当用药情况。在控制其他可能的协变量后,无论我们考虑哪一套明确标准,女性、机构居住状态和多重用药都与不适当用药存在系统性关联。

结论

尽管据报道老年人不适当用药的明确标准在内容上差异较大,但它们在人群层面上对潜在不适当用药患病率的衡量结果相似。

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Eur J Clin Pharmacol. 2014 Jan;70(1):1-11. doi: 10.1007/s00228-013-1575-8. Epub 2013 Sep 10.
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