Saboor Malihe, Kamrani Ahmad-Ali Akbari, Momtaz Yadollah Abolfathi, Sahaf Robab
Iranian Research Centre on Ageing, University of Social Welfare and Rehabilitation Sciences Tehran, Iran.
Iranian Research Centre on Ageing, University of Social Welfare and Rehabilitation Sciences Tehran, Iran, Malaysian Research Institute on Ageing (My Ageing), University Putra Malaysia, Serdang, Selangor, Malaysia.
Med Glas (Zenica). 2019 Feb 1;16(1):121-127. doi: 10.17392/989-19.
Aim Potentially inappropriate medications (PIMs) in older people are associated with the increased use of health care services. The aim of this study was to investigate the prevalence of PIMs among the elderly being referred to pharmacies in Tehran using the Beers criteria of 2012, and identify factors related to PIMs. Methods This cross-sectional study was conducted on elderly patients (60 years and above) referred to pharmacies in Tehran, in 2017. The Beers' criteria 2012 were used to evaluate PIMs. The logistic regression analysis was used to find sociodemographic predictors of PIMs. Results The mean age of 1591 patients was 70.51 years. The overall prevalence of PIMs was 26.0%. The most frequent PIMs, in order of frequency, included diclofenac (13.5%), alprazolam (9.3%), and chlordiazepoxide (9.1%) and clonazepam (8.4%). The pain medications were found to be most common PIMs (37.6%). Polypharmacy (OR=3.64, CI 95%: .81-4.70; p<0.001), number of chronic disease (OR=2.371, CI 95%:1.71-3.28; p<0.001) insomnia (OR=1.45, CI 95%: 1.13-1.87; p<0.01) and type of specialists were found as PIMs risk factors. Internal medicine specialists prescribed PIMs significantly fewer times than other specialists(OR=0.59, CI 95%: 0.40-0.88; p<0.01, and the orthopedic specialists prescribed PIMs significantly more times than other physicians (OR=3.23, CI 95%: 5.76-1.81; p<0.001). Conclusion High prevalence of PIMs among Iranian elderly patients implies a need for the development and operationalization of scientific guidelines for the use of medicines. It is also necessary to hold training courses for physicians to be educated in such cases.
目的 老年人潜在不适当用药（PIMs）与医疗服务使用增加相关。本研究旨在使用2012年Beers标准调查转诊至德黑兰药房的老年人中PIMs的患病率，并确定与PIMs相关的因素。方法 本横断面研究于2017年对转诊至德黑兰药房的老年患者（60岁及以上）进行。采用2012年Beers标准评估PIMs。使用逻辑回归分析寻找PIMs的社会人口学预测因素。结果 1591例患者的平均年龄为70.51岁。PIMs的总体患病率为26.0%。按频率排序，最常见的PIMs包括双氯芬酸（13.5%）、阿普唑仑（9.3%）、氯氮卓（9.1%）和氯硝西泮（8.4%）。发现止痛药物是最常见的PIMs（37.6%）。多重用药（OR=3.64，95%CI：.81 - 4.70；p<0.001）、慢性病数量（OR=2.371，95%CI：1.71 - 3.28；p<0.001）、失眠（OR=1.45，95%CI：1.13 - 1.87；p<0.01）和专科类型被发现为PIMs的危险因素。内科专科医生开具PIMs的次数明显少于其他专科医生（OR=0.59, 95%CI：0.40 - 0.88；p<0.01），而骨科专科医生开具PIMs的次数明显多于其他医生（OR=3.23, 95%CI：5.76 - 1.81；p<0.001）。结论 伊朗老年患者中PIMs的高患病率意味着需要制定和实施科学的用药指南。对医生进行此类情况的培训课程也很有必要。
