Derner Melissa M, Linhart Courtney A, Pederson LeeAnna M, Saju Sarith M, Heiden Alyssa M, Wohlford Lisa A, Swanoski Michael T, Lutfiyya M Nawal
Acute Care Pharmacy Residency Program, Essentia Health System, Duluth, Minnesota, USA.
Consult Pharm. 2016 Sep;31(9):511-7. doi: 10.4140/TCP.n.2016.511.
The Beers criteria list skeletal muscle relaxants (SMR) as inappropriate for individuals 65 years of age and older because of anticholinergic effects, sedation, and risk of falls/fractures. Patients 65 years of age and older presenting to U.S. primary care clinics for injury, prescribed an SMR, are at risk for these events. SMR prescribing patterns in older adults with injury have not been well studied at the population level. Using nationally representative data, the prevalence of older adults prescribed an SMR presenting to U.S. primary care clinics with injury was examined.
A cross-sectional study analyzing 2012 National Ambulatory Medical Care Survey (NAMCS) data using bivariate and multivariate techniques. NAMCS, a nationally representative database of the U.S. population, collects data from primary care office visits and uses a multi-stage sampling strategy.
Primary care offices throughout the United States.
PATIENTS, PARTICIPANTS: Adults 65 years of age and older, presenting to rural primary care clinics with injury.
MAIN OUTCOME MEASURE(S): Prescription for SMR.
Multivariate analysis yielded that the study population presenting to rural clinics for injury had 28% greater odds, non-Caucasian adults had 11% greater odds, and those who had been seen at least twice in the past 12 months had 34% greater odds of being prescribed an SMR. Logistic regression analysis also yielded that females 65 to 74 years of age had greater odds of having a prescription for an SMR.
The results of this study identified disparities among adults 65 years of age and older presenting to U.S. rural primary care clinics with injury and prescribed an SMR. Adults 65 years of age and older, Collaborative.
由于抗胆碱能作用、镇静作用以及跌倒/骨折风险，《Beers标准》将骨骼肌松弛剂（SMR）列为不适用于65岁及以上人群。65岁及以上因受伤前往美国初级保健诊所就诊并被开具SMR处方的患者，面临这些不良事件的风险。在人群层面，针对受伤的老年人使用SMR的处方模式尚未得到充分研究。本研究利用具有全国代表性的数据，调查了因受伤前往美国初级保健诊所就诊且被开具SMR处方的老年人的患病率。
一项横断面研究，使用双变量和多变量技术分析2012年国家门诊医疗护理调查（NAMCS）数据。NAMCS是一个具有全国代表性的美国人群数据库，收集初级保健门诊就诊数据，并采用多阶段抽样策略。
美国各地的初级保健诊所。
患者、参与者：65岁及以上因受伤前往农村初级保健诊所就诊的成年人。
SMR处方。
多变量分析显示，因受伤前往农村诊所就诊的研究人群被开具SMR处方的几率高28%，非白人成年人高11%，在过去12个月内至少就诊过两次的人高34%。逻辑回归分析还显示，65至74岁的女性开具SMR处方的几率更高。
本研究结果确定了65岁及以上因受伤前往美国农村初级保健诊所就诊并被开具SMR处方的成年人之间存在差异。65岁及以上成年人，协作。
