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三种潜在不适当用药标准在我国老年人群中的比较。

Comparison of three criteria for potentially inappropriate medications in Chinese older adults.

机构信息

Pharmacy Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China,

Pharmacy Department of Civil Aviation General Hospital, Beijing, China.

出版信息

Clin Interv Aging. 2018 Dec 28;14:65-72. doi: 10.2147/CIA.S190983. eCollection 2019.

Abstract

OBJECTIVES

This study aimed to compare the prevalence of potentially inappropriate medications (PIMs) among Chinese aged patients using the Beers criteria of 2015, the Screening Tool of Older Persons' Prescriptions (STOPP) of 2014 and the criteria of PIMs for older adults in China (Chinese criteria), and to identify the correlates of the PIMs' use.

METHODS

A retrospective, cross-sectional study was conducted among geriatric patients at Beijing Chao-Yang Hospital between January 2018 and March 2018. Three criteria (the Beers criteria of 2015, the STOPP criteria of 2014 and the Chinese criteria) were used to detect PIMs. A multivariate logistic regression analysis was carried out to determine factors associated with the use of PIMs. Leading PIMs for each set of criteria were also listed. The concordance among the three PIM criteria was calculated using kappa tests.

RESULTS

Totally, 863 inpatients aged ≥65 years were included. The prevalence of patients receiving at least one PIM was 80.2%, 58.1% and 44.0% according to the Chinese criteria, 2015 Beers criteria and 2014 STOPP criteria, respectively. The Beers and the STOPP criteria indicated a moderate coherence, whereas the Chinese criteria showed poor concordance with the other two criteria. Proton-pump inhibitors in the Beers and STOPP criteria and clopidogrel in the PIM-Chinese accounted for most leading PIMs. The most important factor associated with PIM use by all three sets of criteria was the number of prescribed medications.

CONCLUSION

Data showed a high PIM prevalence among older adults in China, which was associated with the number of prescribed medications. The Chinese criteria had the highest detection rate but a poor concordance with the Beers and STOPP criteria (<0.001).

摘要

目的

本研究旨在比较 2015 年版 Beers 标准、2014 年版 STOPP 标准和中国老年人 PIMs 标准(中国标准)在中国老年患者中潜在不适当药物(PIMs)的流行率,并确定 PIMs 使用的相关因素。

方法

2018 年 1 月至 2018 年 3 月,对北京朝阳医院老年患者进行回顾性、横断面研究。采用 2015 年版 Beers 标准、2014 年版 STOPP 标准和中国标准三种标准检测 PIMs。采用多因素 logistic 回归分析确定与 PIM 使用相关的因素。列出了每套标准的主要 PIM。采用 Kappa 检验计算三种 PIM 标准之间的一致性。

结果

共纳入 863 名年龄≥65 岁的住院患者。根据中国标准、2015 年版 Beers 标准和 2014 年版 STOPP 标准,至少有一种 PIM 的患者比例分别为 80.2%、58.1%和 44.0%。Beers 和 STOPP 标准显示中度一致性,而中国标准与其他两个标准一致性较差。Beers 和 STOPP 标准中的质子泵抑制剂和 PIM-中国中的氯吡格雷占大多数主要 PIMs。与所有三种标准相关的 PIM 使用最重要的因素是开具的药物数量。

结论

数据显示,中国老年人的 PIM 患病率较高,与开具的药物数量有关。中国标准的检出率最高,但与 Beers 和 STOPP 标准的一致性较差(<0.001)。

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