Akkawi Muhammad Eid, Nik Mohamed Mohamad Haniki
Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia.
Eur J Hosp Pharm. 2018 Mar;25(e1):e29-e34. doi: 10.1136/ejhpharm-2017-001391. Epub 2018 Jan 6.
To assess the knowledge of physicians and clinical pharmacists about inappropriate prescribing for elderly patients, their confidence in prescribing for elderly patients, and their perceptions of barriers to appropriate prescribing in this population.
A cross-sectional study using a validated 20-item questionnaire was conducted among physicians (n=78) and clinical pharmacists (n=45) working in the medical wards of two tertiary hospitals in Malaysia. Knowledge was assessed by six clinical vignettes which were developed based on Beers criteria and the STOPP/START criteria. Other domains of the study were investigated using a four-point or five-point Likert scale.
Of the 82 participants who completed the questionnaire, 65% were physicians, 90.2% had never received training in geriatric medicine, and 70.8% estimated that 25% or more of their patients were elderly. Only six participants (7.3%) had ever used STOPP/START or Beers criteria when prescribing for elderly patients, and 60% of the respondents had never heard of either one of those criteria. The mean score (SD) for the knowledge part was 3.65 (1.46) points, and only 27 participants (22.9%) scored more than four out of a possible six points. Overall, 34% of the participants rated themselves as confident in prescribing for elderly patients, and this was significantly associated with their knowledge score (P=0.02). The mean number (SD) of barriers cited per participant was 6.88 (2.84), with polypharmacy being the most cited barrier.
The majority of the participants had inadequate knowledge and low confidence regarding recommending medications for elderly patients. Continuing education on geriatric pharmacotherapy may be of value for the hospital physicians and pharmacists.
评估医生和临床药师对老年患者不适当处方的了解情况、他们为老年患者开处方的信心，以及他们对该人群适当处方障碍的看法。
在马来西亚两家三级医院的内科病房工作的医生（n = 78）和临床药师（n = 45）中，使用经过验证的20项问卷进行了一项横断面研究。通过基于Beers标准和STOPP/START标准制定的六个临床病例 vignettes 来评估知识。研究的其他领域使用四点或五点李克特量表进行调查。
在完成问卷的82名参与者中，65% 是医生，90.2% 从未接受过老年医学培训，70.8% 估计他们25% 或更多的患者是老年人。只有六名参与者（7.3%）在为老年患者开处方时曾使用过 STOPP/START 或 Beers 标准，60% 的受访者从未听说过这些标准中的任何一个。知识部分的平均得分（标准差）为3.65（1.46）分，只有27名参与者（22.9%）在可能的6分中得分超过4分。总体而言，34% 的参与者认为自己有信心为老年患者开处方，这与他们的知识得分显著相关（P = 0.02）。每位参与者提到的障碍的平均数量（标准差）为6.88（2.84），多重用药是最常被提及
