1 Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia.
2 National Geriatric Hospital of Vietnam, Hanoi, Vietnam.
Am J Alzheimers Dis Other Demen. 2018 Nov;33(7):423-432. doi: 10.1177/1533317518768999. Epub 2018 Apr 11.
This study examined the use of potentially inappropriate medicines that may affect cognition (PIMcog) in people with dementia and its associated factors. Medical records of all outpatients with dementia attending a tertiary hospital in Vietnam between January 1, 2015, and December 31, 2016, were examined. Medicine use was assessed against a list of PIMcog. Variables associated with having a PIMcog were assessed using a multiple logistic regression. Of the 128 patients, 41% used a PIMcog, 39.1% used cholinesterase inhibitors (CEIs) concomitantly with anticholinergics, and 18% used antipsychotics. The number of hospital visits (adjusted odds ratio [OR]: 1.08; 95% confidence interval [CI]: 1.02-1.16) and number of treating specialists (adjusted OR: 0.61; 95% CI: 0.45-0.83) were associated with PIMcog use. This study highlights a high-level use of medicines that can further impair cognition or reduce the effectiveness of CEIs in people with dementia. Efforts to improve quality use of medicines for this population are warranted.
本研究旨在探讨影响认知的潜在不适当药物（PIMcog）在痴呆患者中的使用情况及其相关因素。我们对 2015 年 1 月 1 日至 2016 年 12 月 31 日期间在越南一家三级医院就诊的所有痴呆门诊患者的病历进行了检查。根据 PIMcog 清单评估药物使用情况。使用多项逻辑回归评估与使用 PIMcog 相关的变量。在 128 名患者中，41%使用了 PIMcog，39.1%同时使用了胆碱酯酶抑制剂（CEIs）和抗胆碱能药物，18%使用了抗精神病药物。就诊次数（调整后的优势比 [OR]：1.08；95%置信区间 [CI]：1.02-1.16）和治疗专家人数（调整后的 OR：0.61；95% CI：0.45-0.83）与 PIMcog 的使用相关。本研究强调了在痴呆患者中使用可能进一步损害认知或降低 CEIs 疗效的药物的高水平现象。有必要努力改善这一人群的药物合理使用。
