Nuñez-Montenegro Antonio, Montiel-Luque Alonso, Martin-Aurioles Esther, Garcia-Dillana Felicisima, Krag-Jiménez Monica, González-Correa Jose A
Care Research Group IBIMA AE-20 INVESCUIDA, Primary Health Care Centre Archidona, Health Area North of Málaga, 29011 Málaga, Spain.
Primary Health Care Centre San Miguel (Torremolinos), Health District Costa del Sol, 29620 Málaga, Spain.
J Clin Med. 2019 Mar 4;8(3):305. doi: 10.3390/jcm8030305.
To asses inappropriate prescribing and its predisposing factors in polymedicated patients over the age of 65 in primary health care.
cross-sectional study.
Primary care centres in the Costa del Sol Health District and Northern Health Area of Malaga in southern Spain.
Patients older than 65 years who use multiple medications. Data collection was conducted during 1 year in a population of 425 individuals who comprised a stratified randomized sample of the population of health care users in the study area. The data were collected by interview on a structured data collection form.
Dependent variable: Potentially inappropriate prescribing (PIP) (STOPP/START criteria). Predictor variables: Sociodemographic characteristics, clinical characteristics and medication use. A descriptive analysis of the variables was performed. Statistical inference was based on bivariate analysis (Student's or Mann-Whitney test and chi-squared test) and multivariate analysis was used to control for confounding factors. 73.6% of participants met one or more STOPP/START criteria. According to information about prescribed treatments, 48.5% of participants met at least one STOPP criterion and 43.30% of them met at least one START criterion. The largest percentage of inappropriate prescriptions was associated with cardiovascular treatments. More than three-quarters of the participants had one or more inappropriate prescriptions for medicines in primary care, according to STOPP/START criteria. In addition, PIP was directly related to the number of prescribed medications, gender and specific pathologies (diabetes).
评估初级卫生保健中65岁以上多药治疗患者的不适当处方及其诱发因素。
横断面研究。
西班牙南部马拉加省太阳海岸健康区和北部健康区的初级保健中心。
使用多种药物的65岁以上患者。在1年时间里，对研究区域内425名医疗保健使用者组成的分层随机样本进行了数据收集。数据通过结构化数据收集表访谈收集。
因变量：潜在不适当处方（PIP）（STOPP/START标准）。预测变量：社会人口学特征、临床特征和药物使用情况。对变量进行了描述性分析。统计推断基于双变量分析（学生t检验或曼-惠特尼U检验以及卡方检验），并使用多变量分析来控制混杂因素。73.6%的参与者符合一项或多项STOPP/START标准。根据所开治疗的信息，48.5%的参与者至少符合一项STOPP标准，其中43.30%的参与者至少符合一项START标准。最大比例的不适当处方与心血管治疗有关。根据STOPP/START标准，超过四分之三的参与者在初级保健中有一项或多项药物的不适当处方。此外，PIP与所开药物的数量、性别和特定疾病（糖尿病）直接相关。
