Baspınar Melike Mercan, Basat Okcan
Dr. Melike Mercan Başpinar, Department of Family Medicine, University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, Istanbul, Turkey.
Dr. Okcan Basat, Department of Family Medicine, University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, Istanbul, Turkey.
Pak J Med Sci. 2020 Jul-Aug;36(5):1063-1068. doi: 10.12669/pjms.36.5.2331.
To assess inappropriate analgesic use (IAU) by comparison of STOPP/START Version-2 and Beers 2019 criteria.
This is a cross-sectional study of 331 elderly patients admitted to family medicine clinics at a tertiary hospital between February and July 2018. Data were collected from face-to-face surveys, including informed patient consent and electronic drug monitoring databases.
The presence of IAU by STOPP version2 was higher than the Beers criteria (19.6%, 14.5%, respectively; P<0.04; Z= -2.5) with a moderate agreement (Kappa= 0.458). The number of drugs and pain score were predictors of IAU. The most commonly caused IAU was diclofenac, although naproxen was the most used analgesic. Almost 39% of diclofenac use, 18.5% of naproxen use, and 33% of etodolac use were IAU. Most commonly, IAU reasons were; (i) NSAID use in hearth failure (Beers) (ii) NSAID use with an antiplatelet agent(s) without PPI (STOPP).
The difference between criteria in terms of IAU was significant in favor of STOPP V2.
通过比较STOPP/START第2版和2019年版Beers标准来评估不适当的镇痛药物使用（IAU）情况。
这是一项横断面研究，研究对象为2018年2月至7月间入住一家三级医院家庭医学诊所的331名老年患者。数据通过面对面调查收集，包括患者知情同意书和电子药物监测数据库。
STOPP第2版所确定的IAU发生率高于Beers标准（分别为19.6%和14.5%；P<0.04；Z=-2.5），一致性一般（Kappa=0.458）。药物数量和疼痛评分是IAU的预测因素。最常导致IAU的药物是双氯芬酸，尽管萘普生是使用最多的镇痛药。几乎39%的双氯芬酸使用、18.5%的萘普生使用和33%的依托度酸使用属于IAU。IAU最常见的原因是：（i）心力衰竭时使用非甾体抗炎药（Beers标准）；（ii）非甾体抗炎药与抗血小板药物联用且未使用质子泵抑制剂（STOPP标准）。
在IAU方面，两种标准之间的差异显著，STOPP第2版更具优势。
