Tommelein Eline, Mehuys Els, Petrovic Mirko, Somers Annemie, Van Damme Charlotte, Pattyn Eva, Mattelin Kristof, Boussery Koen
Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemstesteenweg 460, 9000, Ghent, Belgium.
Department of Internal Medicine, Faculty of Medicine and Health Sciences, De Pintelaan 185, 9000, Ghent, Belgium.
Int J Clin Pharm. 2016 Oct;38(5):1063-8. doi: 10.1007/s11096-016-0366-6. Epub 2016 Aug 8.
Background The Ghent Older People's Prescriptions community Pharmacy Screening (GheOP³S-)tool was recently developed to screen for potentially inappropriate prescribing (PIP). Objective We aimed (1) to determine PIP prevalence in older nursing home (NH) residents with polypharmacy using the GheOP³S-tool and (2) to identify those PIPs that are most frequently detected. Method A cross-sectional study was carried out between February and June 2014 in 10 NHs in Belgium, supplied by a community pharmacy chain. For each NH, 40 residents (≥70 years, using ≥5 chronic drugs) were included. PIP prevalence was determined using the GheOP³S-tool. Results 400 NH residents were included [mean age (±SD) 86.2 (±6.3) years; median number of drugs (±IQR) 10 (7-12)]. A total of 1728 PIPs were detected in 387 (97 %) participants (Median 4; IQR 2-6). The most prevalent items can be assigned to three categories: long-term use of central nervous system drugs (i.e. benzodiazepines, antidepressants and antipsychotics), use of anticholinergic drugs (mutual combinations and with underlying constipation/dementia) and underuse of osteoporosis prophylaxis. Conclusion Screening for PIP by means of the GheOP³S-tool revealed a high prevalence of PIP among older NH residents with polypharmacy. This finding urges for initiatives on the patient-level, but also on a broader, institutional level.
背景 根特老年人处方社区药房筛查（GheOP³S-）工具最近被开发用于筛查潜在不适当处方（PIP）。目的 我们旨在（1）使用GheOP³S-工具确定患有多重用药的老年疗养院（NH）居民中PIP的患病率，以及（2）识别那些最常被检测到的PIP。方法 2014年2月至6月在比利时由一家社区药房连锁供应的10家NH中进行了一项横断面研究。对于每个NH，纳入40名居民（≥70岁，使用≥5种慢性药物）。使用GheOP³S-工具确定PIP患病率。结果 纳入了400名NH居民[平均年龄（±标准差）86.2（±6.3）岁；药物中位数（±四分位间距）10（7-12）]。在387名（97%）参与者中总共检测到1728例PIP（中位数4；四分位间距2-6）。最常见的项目可分为三类：中枢神经系统药物的长期使用（即苯二氮䓬类、抗抑郁药和抗精神病药）、抗胆碱能药物的使用（相互组合以及伴有潜在便秘/痴呆）和骨质疏松症预防措施的使用不足。结论 通过GheOP³S-工具筛查PIP显示，在患有多重用药的老年NH居民中PIP患病率很高。这一发现促使在患者层面以及更广泛的机构层面采取行动。
