Kargar Mona, Atrianfar Fatemeh, Rashidian Arash, Heidari Kazem, Noroozian Maryam, Gholami Kheirollah, Javadi Mohammad Reza
Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran.
Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2019 Dec 19;33:143. doi: 10.34171/mjiri.33.143. eCollection 2019.
The world's population is growing older. Inappropriate and irrational use of drugs in the elderly is a considerable health concern due to consequences such as increased morbidity and adverse drug events. This study aimed to evaluate the rationality of prescribing and determining the extent of inappropriate prescribing in a sample of geriatric patients in Tehran. This cross sectional study was performed on 1512 prescriptions of patients aged ≥ 65 years from 5 pharmacies affiliated to Tehran University of Medical Sciences in 2014. Prescription of potentially inappropriate medications (PIMs) was investigated using the Beers Criteria along with WHO prescribing indices. Date were analyzed using SPSS software, and significance level was set at less than 0.05. Mean (SD) age of patients was 73.9(6.7) years. A total of 472 (31.2%) patients received at least 1 PIM. Benzodiazepines were the most frequent drug class and general practitioners (GPs) were the most frequent prescriber of PIMs. The highest and the lowest percentage of prescriptions containing brand-names were prescribed by subspecialists (62.5%) and GPs (42.2%), respectively. Antibiotics and injectable medications were prescribed for 26.8% and 28.5% of patients by GPs. Mean (SD) number of drugs per prescription was 3.57 (1.92). Prescriptions containing systemic antibiotics and PIMs had significantly higher mean number of drugs compared to those without these items (both P < 0.001). There is a need for interventions to improve the quality of prescribing for elderly patients, especially by GPs. Also, there are still some problems in rational use of drugs based on prescribing indices, especially, prescribing brand-names and injectable medications.
世界人口正在老龄化。老年人用药不当和不合理是一个相当严重的健康问题，因为会导致发病率增加和药物不良事件等后果。本研究旨在评估德黑兰老年患者样本中处方的合理性，并确定不适当处方的程度。这项横断面研究于2014年对来自德黑兰医科大学附属的5家药店的1512份年龄≥65岁患者的处方进行。使用《Beers标准》以及世界卫生组织的处方指标对潜在不适当药物（PIMs）的处方进行调查。数据使用SPSS软件进行分析，显著性水平设定为小于0.05。患者的平均（标准差）年龄为73.9（6.7）岁。共有472名（31.2%）患者至少接受了1种PIM。苯二氮䓬类药物是最常见的药物类别，全科医生（GPs）是PIMs最常见的开方者。含有品牌药的处方中，专科医生开出的比例最高（62.5%），全科医生开出的比例最低（42.2%）。全科医生为26.8%的患者开具了抗生素，为28.5%的患者开具了注射用药物。每张处方的平均（标准差）药物数量为3.57（1.92）。与不包含这些项目的处方相比，含有全身性抗生素和PIMs的处方的平均药物数量显著更高（两者P<0.001）。需要采取干预措施来提高老年患者的处方质量，尤其是全科医生的处方质量。此外，基于处方指标的合理用药仍存在一些问题，特别是品牌药和注射用药物的处方。
