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家庭医生为老年患者开具的潜在不适当药物。

Potentially inappropriate medications prescribed for elderly patients through family physicians.

作者信息

Al Odhayani Abdulaziz, Tourkmani Ayla, Alshehri Mohammed, Alqahtani Hala, Mishriky Adel

机构信息

Family and Community Medicine Department, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.

出版信息

Saudi J Biol Sci. 2017 Jan;24(1):200-207. doi: 10.1016/j.sjbs.2016.05.006. Epub 2016 May 12.

Abstract

The elderly population is increasing throughout the globe, resulting in higher healthcare costs. Potential inappropriate medication (PIM) prescriptions are a major health problem affecting the elderly persons. Due to limited studies in PIM use in primary care and home healthcare in Saudi Arabia, we aim to examine the extent of PIM prescription for and use by elderly patients. This study was carried out with 798 elderly patients, arbitrarily selected from Prince Sultan Medical Military City through the patient register. The mean age of the patients were in the range of 75.2 ± 5.5; 37.8% were males and 62.2% were females. The elderly patients are affected majorly with diabetes (73.9%), hypertension (83.2%) and lipid abnormalities (73.8%). The maximum patients involved in this study were affected with lower hemoglobin levels i.e. 99.2%. Renal impairment was found in 64% and iron supplements were the most commonly used in 23.1%, followed by analgesics and opioids (17%). The 52.5% of participants were using one or more PIMs. Kidney was the only functions and had influence on prescribed decisions. This study indicates PIM is a concern in elderly patients attending clinics and home residents and commonly prescribed ones are atypical antipsychotics, iron overdose, benzodiazepines and opioids. Prescription of drug-drug interactions, cascades and inappropriate drug doses results in preventable adverse effects.

摘要

全球老年人口正在增加,导致医疗保健成本上升。潜在不适当用药(PIM)处方是影响老年人的一个主要健康问题。由于沙特阿拉伯在初级保健和家庭医疗保健中使用PIM的研究有限,我们旨在研究老年患者PIM处方的开具情况及使用情况。本研究对从苏丹王子军事医疗城患者登记册中随机选取的798名老年患者进行。患者的平均年龄在75.2±5.5岁之间;男性占37.8%,女性占62.2%。老年患者主要患有糖尿病(73.9%)、高血压(83.2%)和血脂异常(73.8%)。参与本研究的患者中,血红蛋白水平较低的占比最高,即99.2%。64%的患者存在肾功能损害,23.1%的患者最常使用铁补充剂,其次是镇痛药和阿片类药物(17%)。52.5%的参与者正在使用一种或多种PIM。肾脏是唯一对处方决策有影响的器官。本研究表明,PIM是门诊老年患者和居家老年人的一个问题,常见的处方药物是非典型抗精神病药、铁过量、苯二氮卓类药物和阿片类药物。药物相互作用、级联反应和不适当药物剂量的处方会导致可预防的不良反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/084c/5198987/5f58684faac3/gr1.jpg

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