Luz Aline Cristina, de Oliveira Márcio Galvão, Noblat Lúcia
Hospital Santa Izabel, Rua Dr Clemente Ferreira n. 127, Ed. Geraldo, Apto 202, Canela, Salvador, Bahia, CEP 40110-200, Brazil.
Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia (UFBA), Vitória da Conquista, Bahia, Brazil.
Int J Clin Pharm. 2018 Dec;40(6):1596-1600. doi: 10.1007/s11096-018-0726-5. Epub 2018 Sep 22.
Background Potentially inappropriate prescribing for older people has become a global concern, although few researchers have analyzed potential prescribing omissions for this population. Objective This study aimed to compare the frequency of potential prescribing omissions for elderly patients at their admission to and discharge from a university hospital in northeast Brazil, using the validated and adapted Brazilian START criteria. Setting A university hospital in northeast Brazil. Methods This cross-sectional study examined data from patients who were ≥ 60 years old when they were admitted for > 24 h to a northeastern Brazil teaching hospital during June-December 2016. Main outcome measure Frequency of potential prescribing omissions for elderly patients at their admission to and discharge. Results Data from 227 patients were included. The mean patient age was 71 ± 8.23 years. The patients included 131 women (57.7%), and 176 patients (77.5%) presented with a Charlson Comorbidity Index of ≥ 3. Based on the START criteria, the frequency of potential prescribing omissions was 44.1% (100/227) at the admission and decreased to 39.6% (90/227) at the discharge. The most common potential omissions at the admission were beta-blockers in cases of stable chronic angina, and angiotensin converting enzyme inhibitors or angiotensin receptor blockers in cases of diabetic nephropathy or renal dysfunction. Conclusion The prevalence of potential prescribing omissions among elderly patients remained relatively high at their discharge from a northeastern Brazilian university hospital. The START criteria could be a useful tool to optimize the clinical management of the elderly.
尽管很少有研究人员分析老年人群潜在的处方遗漏情况，但老年人潜在不适当处方已成为全球关注的问题。目的：本研究旨在使用经过验证和调整的巴西START标准，比较巴西东北部一家大学医院老年患者入院时和出院时潜在处方遗漏的频率。地点：巴西东北部的一家大学医院。方法：这项横断面研究检查了2016年6月至12月期间入住巴西东北部一家教学医院超过24小时且年龄≥60岁的患者的数据。主要结局指标：老年患者入院时和出院时潜在处方遗漏的频率。结果：纳入了227例患者的数据。患者的平均年龄为71±8.23岁。其中女性131例（57.7%），176例（77.5%）患者的Charlson合并症指数≥3。根据START标准，入院时潜在处方遗漏的频率为44.1%（100/227），出院时降至39.6%（90/227）。入院时最常见的潜在遗漏是稳定型慢性心绞痛患者未使用β受体阻滞剂，糖尿病肾病或肾功能不全患者未使用血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂。结论：在巴西东北部一家大学医院出院时，老年患者潜在处方遗漏的患病率仍然相对较高。START标准可能是优化老年人临床管理的有用工具。
