Rodríguez-Blanco R, Álvarez-García M, Villalibre-Calderón C, Piña-Ferreras L D, Junquera-Alonso S, Alonso-Lorenzo J C
Centro de Salud de Sabugo, Área Sanitaria III. SESPA, Avilés, Asturias, España.
Centro de Salud Las Vegas, Corvera, Área Sanitaria III, SESPA, Avilés,Asturias, España.
Semergen. 2019 Apr;45(3):180-186. doi: 10.1016/j.semerg.2018.06.004. Epub 2018 Dec 10.
The aim of this study is to determine the rate of potentially inappropriate prescriptions (PIP) in people older than 64 years of age in Avilés, Asturias, Spain.
A descriptive cross-sectional study was conducted in six Health Care Centres. A sample of 400 people was selected, obtained by a random sampling proportional to the population registered in each Health Centre. A review was made of the computerised clinical records, and the STOPP-START (version 2014 with 114 items) criteria were applied to evaluate the PIP.
The study contained 378 (95.5%) patients with a mean age of 75.4 (SD: 7.4) and of which 57.7% were women. Almost all (94.2%: 95% CI; 91.7-96.7) met some PIP criteria. Taking only the STOPP criteria into consideration, 52.4% (95%CI: 47.2-57.6) met at least one breach, and in the START criteria a 90.5% (95%CI; 87.4-93.6), which was reduced to 40.5% (95%CI; 36.4-45.6) if criteria on vaccination were removed. In the STOPP criteria, the most frequent PIP was taking benzodiazepines followed by the use of medication without indications based on the evidence; in the START, the criteria was the anti-pneumococcus vaccination, and the lack of taking vitamin D supplements and calcium in osteoporosis.
There were high levels of PIP, very superior to the previous version, especially for the START criteria. There is a high level of PIP related to the use of benzodiazepines and the use of medication without any clinic evidence. The STOPP-START criteria are useful in Primary Care to assess the PIP.
本研究旨在确定西班牙阿斯图里亚斯省阿维莱斯市64岁以上人群中潜在不适当处方(PIP)的发生率。
在六个医疗保健中心进行了一项描述性横断面研究。通过与每个医疗中心登记人口成比例的随机抽样,选取了400人的样本。对计算机化临床记录进行了审查,并应用STOPP-START(2014版,共114项)标准评估PIP。
该研究纳入了378名(95.5%)患者,平均年龄为75.4岁(标准差:7.4),其中57.7%为女性。几乎所有患者(94.2%:95%置信区间;91.7 - 96.7)都符合某些PIP标准。仅考虑STOPP标准时,52.4%(95%置信区间:47.2 - 57.6)至少符合一项违规标准;在START标准中,这一比例为90.5%(95%置信区间;87.4 - 93.6),如果去除疫苗接种标准,该比例降至40.5%(95%置信区间;36.4 - 45.6)。在STOPP标准中,最常见的PIP是使用苯二氮䓬类药物,其次是根据证据无用药指征的用药情况;在START标准中,标准是抗肺炎球菌疫苗接种,以及骨质疏松症患者未补充维生素D和钙。
PIP水平较高,远高于先前版本,尤其是START标准。与苯二氮䓬类药物的使用以及无任何临床证据的用药情况相关的PIP水平较高。STOPP-START标准在初级保健中评估PIP很有用。