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根据Beers标准、STOPP/START标准和欧盟(7)-PIM清单对葡萄牙老年患者进行药物评估——一项探索性研究。

Medication Evaluation in Portuguese Elderly Patients According to Beers, STOPP/START Criteria and EU(7)-PIM List - An Exploratory Study.

作者信息

Monteiro Cristina, Canário Catarina, Ribeiro Manuel Ângelo, Duarte Ana Paula, Alves Gilberto

机构信息

UFBI - Pharmacovigilance Unit of Beira Interior, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.

CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.

出版信息

Patient Prefer Adherence. 2020 May 5;14:795-802. doi: 10.2147/PPA.S247013. eCollection 2020.

Abstract

PURPOSE

The increase in drug prescription for the elderly raises the risk of the occurrence of potentially inappropriate medications (PIMs), thus increasing the incidence of drug-related problems. Likewise, potential prescribing omissions (PPOs) are also highly prevalent in the elderly. This study aimed at assessing the prevalence of PIMs in the elderly by using the EU(7)-PIM list, STOPP criteria version 2 and the Beers criteria version 2015, as well as the prevalence of PPOs by applying the START criteria version 2 in elderly nursing home residents and outpatients of the Eastern Central Region of Portugal.

PATIENTS AND METHODS

A descriptive cross-sectional study was carried out in a sample of 90 Portuguese elderly people. Age, gender, diagnoses and medication history were collected from the patients' clinical records. The prevalence of PIMs and PPOs was measured according to each of the criteria applied.

RESULTS

The patients' ages ranged from 65 to 103 years, with an average age of 84.15 years. In addition, the average number of medications prescribed was 7.6. The STOPP criteria identified 250 PIMs affecting 77 patients (85.5%), the EU(7)-PIM list detected 94 PIMs in 58 patients (64.4%) and the Beers criteria identified 69 PIMs in 51 patients (56.6%). Therefore, the STOPP criteria version 2 identified substantially more PIMs than the other two tools. Furthermore, by applying the START criteria 68 PPOs were detected in 52 patients (57.7%).

CONCLUSION

A high prevalence of PIMs and PPOs was observed, suggesting the need to implement actions aimed at reducing the phenomenon and thus help to improve the quality of care provided in nursing homes. The variations in prevalence with the different tools suggest the need to carefully choose the tool for medication review in the elderly.

摘要

目的

老年人药物处方的增加提高了潜在不适当用药(PIMs)发生的风险,从而增加了药物相关问题的发生率。同样,潜在处方遗漏(PPOs)在老年人中也非常普遍。本研究旨在通过使用欧盟(7)-PIM清单、2015年版STOPP标准和2015年版Beers标准评估葡萄牙中东部地区老年疗养院居民和门诊患者中PIMs的患病率,以及通过应用2015年版START标准评估PPOs的患病率。

患者与方法

对90名葡萄牙老年人进行了描述性横断面研究。从患者的临床记录中收集年龄、性别、诊断和用药史。根据所应用的每种标准测量PIMs和PPOs的患病率。

结果

患者年龄在65至103岁之间,平均年龄为84.15岁。此外,平均处方药物数量为7.6种。STOPP标准识别出250例影响77名患者(85.5%)的PIMs,欧盟(7)-PIM清单在58名患者(64.4%)中检测到94例PIMs,Beers标准在51名患者(56.6%)中识别出69例PIMs。因此,2015年版STOPP标准识别出的PIMs比其他两种工具多得多。此外,通过应用2015年版START标准,在52名患者(57.7%)中检测到68例PPOs。

结论

观察到PIMs和PPOs的高患病率,表明需要采取行动减少这种现象,从而有助于提高疗养院提供的护理质量。不同工具患病率的差异表明,需要谨慎选择用于老年人用药审查的工具。

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