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尼日利亚西南部一家老年医学中心老年患者中潜在不适当用药情况

Potentially inappropriate medication use among older patients attending a geriatric centre in south-west Nigeria.

作者信息

Akande-Sholabi Wuraola, Adebusoye Lawrence A, Olowookere Olufemi O

机构信息

Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan. Ibadan (Nigeria).

Family Physician and Geriatrician. Chief Tony Anenih Geriatric Centre, University College Hospital. Ibadan (Nigeria).

出版信息

Pharm Pract (Granada). 2018 Jul-Sep;16(3):1235. doi: 10.18549/PharmPract.2018.03.1235. Epub 2018 Sep 14.

Abstract

OBJECTIVES

To determine the prevalence and describe factors associated with the use of potentially inappropriate medication (PIM) among older patients.

METHODS

Cross sectional study of 400 older patients selected systematically at the geriatric centre, University College Hospital, Ibadan between July and September 2016. With the aid of semi-structured questionnaires, information on the socio-demographic characteristics, lifestyle habits, healthcare utilisation and morbidities was obtained. The Beer's criteria 2015 update was used to identify the PIMs. Predictors of PIMs were determined using multivariate analyses at alpha 0.05.

RESULTS

Age was 70.2 (SD=5.9) years and 240 (60%) were females. General prescription pattern showed antihypertensives (34.7%) as the commonest medications used. The point prevalence of PIMs use was 31%. In all, 10 PIMs were used by the respondents. The majority (81.5%) were using one PIM, while (17.7%) used two PIMs and (0.8%) 3 PIMs. NSAIDs (72.6%) were the commonest PIMs identified, followed by the benzodiazepines (24.2%). Respondents had an average of 1.9 morbidities, and mulitmorbidity found in 60.5%. Logistic regression analysis showed self-rated health assessed as better compared with age-mates [OR =1.718 (1.080-2.725)] and being physically active [OR =1.879 (1.026-3.436)] as the most significantly associated with PIMs use.

CONCLUSIONS

The use of PIMs among older patients in our setting was high with NSAIDs being the most frequently used medications. An interdisciplinary approach, of medication review by pharmacists', working with physicians may improve prescribing practices among older persons. Therefore, it is necessary to create public health awareness on the use of PIMs among older persons.

摘要

目的

确定老年患者中潜在不适当用药(PIM)的流行情况,并描述与之相关的因素。

方法

2016年7月至9月间,在伊巴丹大学学院医院老年医学中心对400名老年患者进行横断面研究。借助半结构化问卷,获取了社会人口学特征、生活方式习惯、医疗保健利用情况和发病率等信息。采用2015年更新的Beer标准来识别PIM。使用多变量分析确定PIM的预测因素,α值为0.05。

结果

年龄为70.2(标准差=5.9)岁,240名(60%)为女性。一般处方模式显示,抗高血压药物(34.7%)是最常用的药物。PIM使用的时点患病率为31%。受访者总共使用了10种PIM。大多数(81.5%)使用一种PIM,而(17.7%)使用两种PIM,(0.8%)使用三种PIM。非甾体抗炎药(72.6%)是最常见的已识别PIM,其次是苯二氮䓬类药物(24.2%)。受访者平均有1.9种疾病,60.5%的人患有多种疾病。逻辑回归分析显示,与同龄人相比,自我评估健康状况较好[比值比=1.718(1.080-2.725)]以及身体活跃[比值比=1.879(1.026-3.436)]与PIM使用最显著相关。

结论

在我们所研究的环境中,老年患者中PIM的使用情况很普遍,非甾体抗炎药是最常用的药物。药剂师与医生合作进行药物审查的跨学科方法可能会改善老年人的处方行为。因此,有必要提高公众对老年人使用PIM的健康意识。

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