Pharmacology, Clinical Pharmacy and Quality Control Laboratory, Faculty of Pharmacy, Saint-Joseph University of Beirut, Lebanon; Faculty of Pharmacy, Saint-Joseph University of Beirut, Lebanon.
Faculty of Pharmacy, Saint-Joseph University of Beirut, Lebanon; Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon; Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon; Faculty of Pharmacy, Lebanese University, Hadath, Lebanon; Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center Inserm-Université de Bordeaux, Bordeaux, France; INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon.
Arch Gerontol Geriatr. 2018 Sep-Oct;78:132-138. doi: 10.1016/j.archger.2018.06.009. Epub 2018 Jun 22.
To assess and compare, according to Beers and STOPP criteria, the frequency and causes of potentially inappropriate medications (PIMs) in elderly, as well as the relationship between PIMs use and patient's treatment satisfaction, evaluated using the Treatment Satisfaction Questionnaire for Medications (TSQM).
350 patients (mean age = 73.49 years), taking a total of 1893 medications, were enrolled from community pharmacies.
6.2% and 20.4% of the medications were inappropriate according to the STOPP and Beers lists respectively; 103 (29.4%) and 210 (60%) patients had at least one PIM according to STOPP and Beers criteria respectively. The most common cause of PIM was a full dose of proton pomp inhibitor for >8 weeks (STOPP) and using a drug that exacerbates/causes syndrome of inappropriate antidiuretic hormone secretion (Beers). The number of medications taken by the participant, advanced age, female gender, prescription of medications for anxiety/depression, ulcers/gastroesophageal reflux, rheumatoid arthritis and epilepsy significantly increased the PIMs number. When using STOPP criteria, all TSQM subscale scores were significantly lower among patients with PIM use compared to those without PIM. The same trend was observed for Beers critertia, with a significant difference reached for side effects and convenience subscales only.
Selecting the appropriate tools to assess PIMs, prescribers and patient education regarding the risks associated with PIMs, and patient's perception and satisfaction regarding his treatment, are critical issues to be addressed among older adults.
根据 Beers 和 STOPP 标准评估和比较老年人中潜在不适当药物(PIM)的频率和原因,并使用药物治疗满意度问卷(TSQM)评估 PIM 使用与患者治疗满意度之间的关系。
从社区药房招募了 350 名(平均年龄=73.49 岁)患者,共服用 1893 种药物。
根据 STOPP 和 Beers 清单,分别有 6.2%和 20.4%的药物是不适当的;根据 STOPP 和 Beers 标准,分别有 103(29.4%)和 210(60%)名患者至少有一种 PIM。PIM 的最常见原因是质子泵抑制剂全剂量使用>8 周(STOPP)和使用会加剧/引起不适当抗利尿激素分泌综合征的药物(Beers)。参与者服用的药物数量、年龄较大、女性、焦虑/抑郁、溃疡/胃食管反流、类风湿关节炎和癫痫的药物处方显著增加了 PIM 的数量。当使用 STOPP 标准时,与无 PIM 使用的患者相比,使用 PIM 的患者的所有 TSQM 子量表评分均显著降低。Beers 标准也观察到了相同的趋势,仅在副作用和便利性子量表上存在显著差异。
选择适当的工具来评估 PIM、向患者和处方者提供有关 PIM 相关风险的教育,以及患者对其治疗的感知和满意度,是老年人需要解决的关键问题。