Endres Heinz G, Kaufmann-Kolle Petra, Knopf Hildtraud, Thürmann Petra A
AQUA-Institut Göttingen, Maschmühlenweg 8-10, 37073, Göttingen, Deutschland.
Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018 Jan;61(1):40-51. doi: 10.1007/s00103-017-2654-2.
Recent studies demonstrate a relationship between the prescription of potentially inappropriate medications (PIM) for patients 65 years or older and an increased risk for adverse events, in particular hospitalisations. The RKI conducted DEGS1-Survey ("German health interview and examination survey for adults") provides a representative sample of the target population to identify determinants for PIM use.
The aim of this study was to determine characteristics of older persons in Germany, who currently use PIM, and if there are subpopulations among older persons with a particularly high PIM use.
Within the DEGS1-Survey a total of 175 variables regarding health and social aspects were documented from 1392 community-dwelling persons between 65 and 79 years of age, and medication intake during the last seven days was recorded. PIM drugs were identified according to the PRISCUS list. Associations between PIM use and variables recorded were evaluated by means of multivariate statistical models.
Within seven days before the survey PIM drugs were used by 13.0% (95%-CI: 10.7-15.6) of the respondents. The following factors significantly increase the risk for receiving a PIM: number of drugs taken in the last seven days; number of visits to different physician specialists during the last 12 months; sleep disorders; psychiatric condition, and diseases affecting the musculoskeletal system. The majority of PIMs were antidepressants and anxiolytics/sedatives. Elderly women with depression, sleep disorders, and a need for analgesics are particularly affected by increased PIM use. They deserve special attention in this regard.
近期研究表明,65岁及以上患者使用潜在不适当药物(PIM)与不良事件风险增加,尤其是住院风险增加之间存在关联。德国罗伯特·科赫研究所开展的DEGS1调查(“德国成人健康访谈与检查调查”)提供了目标人群的代表性样本,以确定PIM使用的决定因素。
本研究的目的是确定德国目前使用PIM的老年人的特征,以及老年人中是否存在PIM使用特别高的亚人群。
在DEGS1调查中,记录了1392名65至79岁社区居住者的总共175个关于健康和社会方面的变量,并记录了过去七天的药物摄入情况。根据PRISCUS清单确定PIM药物。通过多变量统计模型评估PIM使用与记录变量之间的关联。
在调查前七天内,13.0%(95%置信区间:10.7-15.6)的受访者使用了PIM药物。以下因素会显著增加接受PIM的风险:过去七天服用的药物数量;过去12个月内拜访不同专科医生的次数;睡眠障碍;精神状况以及影响肌肉骨骼系统的疾病。大多数PIM是抗抑郁药和抗焦虑药/镇静剂。患有抑郁症、睡眠障碍且需要镇痛的老年女性受PIM使用增加的影响尤为明显。在这方面她们值得特别关注。