Department of Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.
Kawakita Center for Family Medicine, Kawakita General Hospital, Tokyo, Japan.
Geriatr Gerontol Int. 2017 Dec;17(12):2520-2526. doi: 10.1111/ggi.13128. Epub 2017 Aug 31.
The use of potentially inappropriate medications (PIMs) for older patients is a major public health problem. However, there is little information regarding PIMs in Japanese primary care settings, and the association between psychological problems and PIMs is unknown. The present study was carried out to explore the prevalence of PIMs among older patients in a primary care setting in Tokyo, and to assess the association between PIMs and depression and anxiety.
A cross-sectional study in a Japanese outpatient clinic providing primary care was carried out. Data were collected from January 2016 to March 2016. A total of 740 patients aged ≥65 years with chronic diseases were enrolled. Information regarding sociodemographic status, comorbidities, and prescription and psychological status was collected using a questionnaire that patients were required to complete, and by reviewing the patients' medical records.
The Screening Tool of Older Person's Prescriptions criteria version 2 revealed PIM prescription for 32.3% of patients. Benzodiazepines, hypnotic Z-drugs and proton pump inhibitors accounted for a majority of PIMs. After adjusting for age, sex, comorbidities, estimated glomerular filtration rate and the number of medications, anxiety was identified as a predictor for PIMs.
PIMs among older patients are common in Japanese primary care settings, and prescription of benzodiazepines or hypnotic Z-drugs and proton pump inhibitors was frequent as PIMs. PIMs might be associated with anxiety; therefore, their association should be focused on and addressed to reduce PIMs. Geriatr Gerontol Int 2017; 17: 2520-2526.
老年人使用潜在不适当药物(PIMs)是一个主要的公共卫生问题。然而,关于日本初级保健环境中 PIMs 的信息很少,PIMs 与心理问题之间的关系也不清楚。本研究旨在探讨东京初级保健环境中老年人中 PIMs 的流行情况,并评估 PIMs 与抑郁和焦虑之间的关系。
在一家提供初级保健的日本门诊诊所进行了一项横断面研究。数据收集于 2016 年 1 月至 2016 年 3 月。共纳入 740 名年龄≥65 岁且患有慢性病的患者。使用患者需要填写的问卷和回顾患者病历收集了社会人口统计学状况、合并症以及处方和心理状况的信息。
使用老年人处方筛选工具 2 版本发现 32.3%的患者存在 PIM 处方。苯二氮䓬类、催眠 Z 类药物和质子泵抑制剂占 PIMs 的大部分。在校正年龄、性别、合并症、估计肾小球滤过率和药物数量后,焦虑被确定为 PIMs 的预测因素。
在日本初级保健环境中,老年人中 PIMs 很常见,苯二氮䓬类或催眠 Z 类药物和质子泵抑制剂的处方很常见,是 PIMs。PIMs 可能与焦虑有关;因此,应关注并解决 PIMs 问题,以减少 PIMs 的使用。