[农村卫生区域65岁以上多药联用患者不适当处方的患病率]
[Prevalence of inappropriate prescription to polymedicated patients over 65 years old in a rural health area].
作者信息
Terol-Fernández J, Faus-Felipe V, Díez-Rodríguez M, del Rio-Urenda S, Labajos-Manzanares M T, González-Correa J A
机构信息
Enfermería, Área de Gestión Sanitaria Este de Málaga, Rincón de la Victoria, Málaga, España.
Farmacia, Agencia Sanitaria Costa del Sol, Málaga, España.
出版信息
Rev Calid Asist. 2016 Mar-Apr;31(2):84-98. doi: 10.1016/j.cali.2015.08.006. Epub 2015 Nov 17.
OBJECTIVE
Describe the inappropriate prescription to polymedicated patients over 65 years old in rural areas.
MATERIAL AND METHOD
An observational, descriptive, cross-sectional study conducted in health care units in the Guadalhorce Valley, a rural area of Malaga, Spain. The district has a catchment population of about 144,993 inhabitants. This study is focused on the population that is older than 65 years, and who use 10 or more medications (4.344 patients). The study has as a primary variable: the rates of inappropriate prescription. These are classified using the Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, as well as the criteria of the strategy of the approach to polymedicated of the Andalusian Health System. An application was used to create individualised forms that identified inappropriate prescribing criteria. For each patient, we used variables, such as the unit, drug group, medications, dose, and use of the STOPP and Andalusian Health System criteria were recorded for each patient.
RESULTS
More than one-third (35.5%) of all patients have inappropriate prescription, according to STOPP criteria, related to some health problem (direct problems). The large majority (94%) have potentially inappropriate prescription according to the criteria of the Andalusian Health System. If the criteria directly related to prescribing medication for people over 65 (general) is taken into account, 100% of patients have some form of inappropriate or potentially inappropriate prescribing.
CONCLUSIONS
The prevalence of polypharmacy and inappropriate prescription is a real problem in the population over 65 years old. An informatics tool provides us with the facilities to identify and approach inappropriate prescribing.
目的
描述农村地区65岁以上多药联用患者的不适当处方情况。
材料与方法
在西班牙马拉加农村地区瓜达尔霍斯山谷的医疗保健单位进行了一项观察性、描述性横断面研究。该地区的服务人口约为144,993名居民。本研究聚焦于65岁以上且使用10种或更多药物的人群(4344名患者)。该研究的主要变量为:不适当处方率。使用老年人潜在不适当处方筛查工具(STOPP)标准以及安达卢西亚卫生系统多药联用处理策略的标准对其进行分类。使用一个应用程序创建个性化表格,以识别不适当处方标准。对于每位患者,我们使用了诸如科室、药物类别、药物、剂量等变量,并记录了每位患者的STOPP标准和安达卢西亚卫生系统标准的使用情况。
结果
根据STOPP标准,超过三分之一(35.5%)的患者存在与某些健康问题(直接问题)相关的不适当处方。根据安达卢西亚卫生系统的标准,绝大多数(94%)患者存在潜在不适当处方。如果考虑与65岁以上人群(一般情况)用药直接相关的标准,100%的患者存在某种形式的不适当或潜在不适当处方。
结论
多重用药和不适当处方的患病率在65岁以上人群中是一个实际问题。一种信息学工具为我们提供了识别和处理不适当处方的便利。