College of Pharmacy, Medical University of South Carolina, 280 Calhoun Street, QE213C MSC140, Charleston, SC, 29425, USA.
Drugs Aging. 2020 Jul;37(7):529-537. doi: 10.1007/s40266-020-00770-1.
Potentially inappropriate medications (PIMs) are defined by the American Geriatric Society as medications that should be avoided in the elderly in general, or in specific situations. However, PIM use remains high among aging populations and may result in increased utilization of healthcare resources.
The aim of this meta-analysis was to evaluate the impact of PIM use on hospital encounters among older adults.
We searched Medline and Scopus from January 1991 to April 2019 using keywords and MeSH terms related to PIMs. Studies were included if they compared the odds of hospital encounters between PIM and non-PIM groups. Hospital encounters could be either hospital admissions or emergency department (ED) visits. Using random-effects meta-analytic methods, we calculated the pooled odds of any hospital encounter in PIM versus non-PIM users.
A total of 21 studies evaluating 3,137,188 patients were included. The proportion of patients on PIMs was > 20% in most (n = 18) studies, median follow up was 12 months, and the mean age of patients ranged from 72 to 86 years. Upon meta-analysis, PIM use was associated with increased odds of both hospital admissions (OR 1.52; 95% CI 1.40-1.65) and ED visits (OR 1.72, 95% CI 1.33-2.24).
PIM use among older patients was associated with more hospital encounters. These unnecessary encounters likely cause a substantial burden to the healthcare system and patients.
美国老年医学会将潜在不适当药物（PIMs）定义为一般老年人或特定情况下应避免使用的药物。然而，老年人中 PIM 的使用仍然很高，可能导致医疗保健资源的利用增加。
本荟萃分析旨在评估 PIM 使用对老年患者住院的影响。
我们使用与 PIM 相关的关键字和 MeSH 术语，从 1991 年 1 月至 2019 年 4 月在 Medline 和 Scopus 中进行了搜索。如果研究比较了 PIM 组和非 PIM 组之间住院的几率，则将其纳入研究。住院可包括住院或急诊部（ED）就诊。使用随机效应荟萃分析方法，我们计算了 PIM 与非 PIM 使用者任何住院的汇总几率。
共有 21 项研究评估了 3137188 名患者。大多数研究（n=18）中 PIM 患者的比例超过 20%，中位随访时间为 12 个月，患者的平均年龄范围为 72 至 86 岁。荟萃分析显示，PIM 使用与住院（OR 1.52；95%CI 1.40-1.65）和 ED 就诊（OR 1.72，95%CI 1.33-2.24）的几率增加相关。
老年患者中 PIM 的使用与更多的住院相关。这些不必要的就诊可能给医疗保健系统和患者带来巨大负担。
