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[巴塞罗那高龄机构化人群:根据Frail-VIG指数评估虚弱状况并依据STOPP-虚弱标准分析治疗适宜性]

[Very elderly institutionalised population of Barcelona: Evaluation of frailty according to the Frail-VIG index and analysis of therapeutic appropriateness according to the STOPP-frail criteria].

作者信息

Vivanco María Victoria, Formiga Francesc, Mundet Riera Imma, San José Laporte Antonio, Curto Prieto David

机构信息

Equipos de Atención a Residencias Geriátricas, Grup Mutuam, Barcelona, España.

Unidad de Geriatría, Servicio Medicina Interna, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España.

出版信息

Rev Esp Geriatr Gerontol. 2019 Nov-Dec;54(6):334-338. doi: 10.1016/j.regg.2019.06.004. Epub 2019 Jul 28.

Abstract

INTRODUCTION

As frailty and multiple drug therapy often coexists in institutionalised elderly patients, it is important to assess the level of frailty and therapeutic appropriateness in this population group. The aim of the study is to: assess the frailty level of institutionalised elderly patients and to analyse their prescriptions.

MATERIAL AND METHODS

An observational and cross-sectional study of a geriatric population of 85 years or older, institutionalised in a nursing home in Barcelona. Frailty was assessed using the Frail-VIG index, and the adequacy of the prescription of each group was done according to the STOPP-Frail Criteria.

RESULTS

The study included 79 patients, with a mean age of 90.9±4.2 years. Most of them (96.2%) had some degree of frailty. Slight frailty was observed in 21.5%, moderate in 37.7%, and advanced in 38%. The patients were prescribed a median of 7 drugs. No statistically significant differences were found in the majority of the prescriptions of the frailty groups. Differences were only found for those who had difficulty taking the medication, those who took medication for prostatic hypertrophy, and nutritional supplements. In all 3 groups, it was found that up to one third of the prescription was inappropriate, and some were even contraindicated in the most frail patients.

CONCLUSION

The elderly study population has a high frailty index with a high prevalence of multiple drug therapy with inappropriate prescription. The poor individualisation of these prescriptions in relation to the level of frailty, especially in those with short life prognosis, is a situation that should be improved.

摘要

引言

由于衰弱与多种药物治疗在机构养老的老年患者中经常并存,因此评估该人群的衰弱程度和治疗适宜性非常重要。本研究的目的是:评估机构养老老年患者的衰弱程度并分析他们的处方。

材料与方法

对巴塞罗那一家养老院中85岁及以上的老年人群进行观察性横断面研究。使用Frail-VIG指数评估衰弱情况,并根据STOPP-Frail标准评估每组处方的合理性。

结果

该研究纳入了79名患者,平均年龄为90.9±4.2岁。他们中的大多数(96.2%)有一定程度的衰弱。观察到轻度衰弱的占21.5%,中度衰弱的占37.7%,重度衰弱的占38%。患者的药物处方中位数为7种。在衰弱组的大多数处方中未发现统计学上的显著差异。仅在服药有困难的患者、服用前列腺增生药物的患者以及营养补充剂方面发现了差异。在所有3组中,发现高达三分之一的处方是不合适的,有些甚至在最衰弱的患者中是禁忌的。

结论

老年研究人群衰弱指数较高,多种药物治疗且处方不当的患病率较高。这些处方相对于衰弱程度的个体化不足,尤其是在预期寿命较短的患者中,这种情况应予以改善。

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