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老年人入院和出院时潜在不适当用药情况:Beers 2019标准与2015标准的比较

Potentially inappropriate medications at admission and discharge in older adults: A comparison of the Beers 2019 and 2015 criteria
.

作者信息

Wang Feifei, Ma Zhuo, Liu Meng, Wu Xinan

出版信息

Int J Clin Pharmacol Ther. 2020 Jun;58(6):299-309. doi: 10.5414/CP203638.

Abstract

BACKGROUND

Potentially inappropriate medications (PIMs) for older adults are those with an unfavorable risk-benefit ratio when more effective and safe therapeutic alternatives are available. PIMs represent an important public health problem.

AIM

The study aimed to investigate the prevalence of PIM at admission and discharge identified by the Beers 2019 and 2015 criteria in older patients in China and to identify the correlates of PIMs.

MATERIALS AND METHODS

This was a cross-sectional study conducted in a tertiary hospital in China. Hospitalized patients in the internal medicine department aged ≥ 60 years were enrolled from June 2018 to October 2018. Information on medications at admission and discharge was collected and evaluated regarding PIMs using Beers 2019 and 2015 criteria. The concordance between PIM use according to Beers 2019 and 2015 criteria was calculated using κ tests. Multivariate logistic regressions were used to evaluate the factors associated with PIM use.

RESULTS

Totally, 604 patients aged ≥ 60 years were included. The prevalence of PIM at admission was 53.3 and 55.0% according to the Beers 2015 and 2019 criteria, whereas the prevalence of PIM at discharge was 32.0 and 33.4% according to both criteria. The most frequent PIMs at admission and discharge were both diuretics according to the Beers 2019 criteria. PIMs at admission and discharge identified by the Beers 2019 criteria were both associated with the number of prescribed medications, acute heart failure, and chronic heart failure.

CONCLUSION

The Beers 2019 and 2015 criteria showed good accordance in our study.

摘要

背景

对于老年人而言,潜在不适当用药(PIMs)是指在有更有效且安全的治疗选择时,风险效益比不佳的药物。PIMs是一个重要的公共卫生问题。

目的

本研究旨在调查中国老年患者入院和出院时根据2019年和2015年Beers标准确定的PIMs患病率,并确定PIMs的相关因素。

材料与方法

这是一项在中国一家三级医院进行的横断面研究。纳入了2018年6月至2018年10月内科≥60岁的住院患者。收集入院和出院时的用药信息,并根据2019年和2015年Beers标准评估PIMs。使用κ检验计算根据2019年和2015年Beers标准使用PIMs的一致性。采用多因素逻辑回归评估与使用PIMs相关的因素。

结果

共纳入604例≥60岁的患者。根据2015年和2019年Beers标准,入院时PIMs的患病率分别为53.3%和55.0%,而根据这两个标准,出院时PIMs的患病率分别为32.0%和33.4%。根据2019年Beers标准,入院和出院时最常见的PIMs均为利尿剂。根据2019年Beers标准确定的入院和出院时的PIMs均与处方药物数量、急性心力衰竭和慢性心力衰竭有关。

结论

在我们的研究中,2019年和2015年Beers标准显示出良好的一致性。

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