Mo Li, Ding Ding, Pu Shi-Yun, Liu Qin-Hui, Li Hong, Dong Bi-Rong, Yang Xiao-Yan, He Jin-Han
Department of Pharmacy; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Chin Med J (Engl). 2016 Jan 5;129(1):22-7. doi: 10.4103/0366-6999.172558.
Polypharmacy and potentially inappropriate medications (PIMs) are prominent prescribing issues in elderly patients. This study was to investigate the different prevalence of PIM use in elderly inpatients between 65-79 years of age and 80 years or older, who were discharged from Geriatric Department in West China Hospital.
A large-scale cohort of 1796 inpatients aged 65 years or over was recruited. Respectively, 618 patients were 65-79 years and 1178 patients were 80 years or older. Updated 2012 Beers Criteria by the American Geriatric Society was applied to assess the use of PIM among the investigated samples.
A review of the prescribed medications identified 686 patients aged 80 years or older consumed at least one PIM giving a rate of 58.2%. Conversely, 268 (43.4%) patients aged 65-79 years consumed at least one PIM (χ2 = 40.18, P < 0.001). Patients aged 80 years or older had higher hospitalization expenses, length of stay, co-morbidities, medical prescription, and mortality than patients aged 65-79 years (all with P < 0.001). Patients aged 80 years or older were prescribed with more benzodiazepines, drugs with strong anticholinergic properties, megestrol, antipsychotics, theophylline, and aspirin. In multiple regression analysis, PIM use was significantly associated with female gender, age, number of diagnostic disease, and number of prescribed medication.
The finding from this study revealed that inpatients aged 80 years or older encountered more PIM use than those aged 65-79 years. Anticholinergic properties, megestrol, antipsychotics, theophylline, and aspirin are medications that often prescribed to inpatients aged 80 years or older. Doctors should carefully choose drugs for the elderly, especially the elderly aged 80 years or older.
多重用药和潜在不适当用药(PIMs)是老年患者中突出的处方问题。本研究旨在调查华西医院老年医学科出院的65至79岁和80岁及以上老年住院患者中PIM使用的不同患病率。
招募了一个由1796名65岁及以上住院患者组成的大规模队列。其中,618名患者年龄在65至79岁之间,1178名患者年龄在80岁及以上。应用美国老年医学会2012年更新的Beers标准来评估被调查样本中PIM的使用情况。
对所开药物的审查发现,686名80岁及以上的患者至少使用了一种PIM,使用率为58.2%。相反,268名(43.4%)65至79岁的患者至少使用了一种PIM(χ2 = 40.18,P < 0.001)。80岁及以上的患者比65至79岁的患者有更高的住院费用、住院时间、合并症、药物处方和死亡率(所有P < 0.001)。80岁及以上的患者被开了更多的苯二氮䓬类药物、具有强抗胆碱能特性的药物、甲地孕酮、抗精神病药物、茶碱和阿司匹林。在多元回归分析中,PIM的使用与女性性别、年龄、诊断疾病数量和处方药物数量显著相关。
本研究结果显示,80岁及以上的住院患者比65至79岁的患者遇到更多的PIM使用情况。抗胆碱能特性药物、甲地孕酮、抗精神病药物、茶碱和阿司匹林是经常开给80岁及以上住院患者的药物。医生应为老年人,尤其是80岁及以上的老年人谨慎选择药物。