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韩国老年医学中使用 Beers 标准药物的患者有发生药物不良事件的风险。

South Korean geriatrics on Beers Criteria medications at risk of adverse drug events.

机构信息

Seoul National University Biomedical Informatics (SNUBI), Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Korea.

Precision Medicine Center, Seoul National University Hospital, Seoul, Korea.

出版信息

PLoS One. 2018 Mar 15;13(3):e0191376. doi: 10.1371/journal.pone.0191376. eCollection 2018.

Abstract

BACKGROUND

The Beers Criteria released by the American Geriatrics Society includes a list of drugs to avoid in the geriatric population and is frequently used as a safety resource in geriatric pharmacotherapy.

OBJECTIVE

To evaluate the exposure of South Korean geriatrics to potentially inappropriate medications according to the Beers Criteria and the risk of adverse events from these medications.

METHODS

This study included medications recommended to be avoided in patients 65 years or older regardless of concomitant drug therapy or disease. The exposure of South Korean geriatrics to each of the study medications were examined using health claims data of 2011. The number of South Korean geriatrics at risk of experiencing adverse drug events from the study medications were estimated by multiplying the number of patients exposed to the medication in 2011 and the incident rate of the event obtained from literature sources.

RESULTS

This study examined 166,822 geriatrics for Beers Criteria medication exposure and adverse drug event risk. The most prevalent Beers Criteria medication prescribed in South Korean geriatrics >1 day was chlorpheniramine (53.9%) and the adverse drug event with the highest number of this geriatric population at risk of was amitriptyline related dry mouth (4.9%). The proportion of South Korean geriatrics on chronic Beers Criteria medications >1 day at risk of adverse drug events from these medications was significantly higher than in US geriatrics (0.005 vs. 0.001, 2-way ANOVA post hoc pairwise t-test P<0.0001).

CONCLUSIONS

In 2011, over half of South Korean geriatrics was exposed to medications recommended to be avoided in geriatrics and their adverse drug event risk warrants close monitoring of their occurrence.

摘要

背景

美国老年医学会发布的 Beers 标准包括一份老年人应避免使用的药物清单,该标准常被用作老年药物治疗的安全资源。

目的

根据 Beers 标准评估韩国老年人使用潜在不适当药物的情况以及这些药物引起不良事件的风险。

方法

本研究纳入了建议所有 65 岁及以上患者避免使用的药物,无论其是否正在接受药物治疗或患有其他疾病。本研究使用 2011 年健康索赔数据来评估韩国老年人对每种研究药物的暴露情况。根据文献来源获得的事件发生率,将 2011 年暴露于研究药物的患者人数与因药物而发生不良事件的风险人数相乘,来估计发生不良药物事件的韩国老年人人数。

结果

本研究对 166822 名符合 Beers 标准的韩国老年人进行了药物暴露和不良药物事件风险评估。韩国老年人中最常被处方的 Beers 标准药物为氯苯那敏(53.9%),风险最高的不良药物事件为阿米替林相关口干(4.9%)。每日使用慢性 Beers 标准药物的韩国老年人发生这些药物引起的不良药物事件的风险比例明显高于美国老年人(0.005 比 0.001,双因素方差分析事后两两 t 检验 P<0.0001)。

结论

2011 年,超过一半的韩国老年人使用了建议避免在老年人中使用的药物,他们发生不良药物事件的风险需要密切监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3cb9/5854240/6c12981ebef7/pone.0191376.g001.jpg

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