Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan.
Sapporo Nishimaruyama Hospital, Sapporo, Japan.
Geriatr Gerontol Int. 2020 Oct;20(10):961-966. doi: 10.1111/ggi.14009. Epub 2020 Aug 19.
Studies of medication use in patients with a percutaneous endoscopic gastrostomy (PEG) tube have not been conducted adequately. The aim of this study was to describe medication use of care-dependent older adults with PEG and evaluate whether potential prescribing omissions (PPO) would affect the cause of death or acute illness.
In a geriatric long-term care hospital, 116 inpatients aged ≥65 years with insertion of a PEG tube because of dysphagia were enrolled and followed for 2 years: 2016-2018. The patients were divided into two groups, i.e., group A (who died between 2016 and 2018) and group B (who continued to be hospitalized in 2018). Clinical data and prescribed medications were recorded. Logistic regression models were conducted to assess the associations between survival and variables: age, gender, serum albumin level, serum creatinine level, body mass index (BMI), number of drugs and PPO.
The patients' mean age was 85.3 ± 10.2 years, 57.8% were women and the mean number of drugs was 6.8 ± 3.5. Medications for managing symptoms, such as constipation and gastrointestinal symptoms, were commonly prescribed. The most common PPO medications were antiplatelet agents and anticoagulants. On logistic regression analysis, PPO had no influence on the cause of death or acute illness. Lower age, higher serum albumin level and body mass index were associated with survival in both univariate and multivariate models.
Polypharmacy was prevalent in patients with PEG. Given the finding that PPO had no influence on health outcome, rational deprescribing could be warranted. Geriatr Gerontol Int 2020; 20: 961-966.
经皮内镜胃造口术（PEG）管患者的用药研究尚未充分进行。本研究旨在描述依赖 PEG 的老年患者的用药情况，并评估潜在的用药遗漏（PPO）是否会影响死亡或急性疾病的原因。
在一家老年长期护理医院，共纳入了 116 名因吞咽困难而插入 PEG 管且年龄≥65 岁的住院患者，并对其进行了 2 年的随访：2016-2018 年。患者被分为两组，即 A 组（2016 年至 2018 年期间死亡的患者）和 B 组（2018 年仍住院的患者）。记录了临床数据和开具的药物。使用逻辑回归模型评估了生存与以下变量之间的关联：年龄、性别、血清白蛋白水平、血清肌酐水平、体重指数（BMI）、用药数量和 PPO。
患者的平均年龄为 85.3±10.2 岁，57.8%为女性，平均用药数量为 6.8±3.5。常用的治疗药物包括治疗便秘和胃肠道症状等症状的药物。最常见的 PPO 药物是抗血小板药物和抗凝剂。在逻辑回归分析中，PPO 对死亡或急性疾病的原因没有影响。在单变量和多变量模型中，较低的年龄、较高的血清白蛋白水平和 BMI 与生存有关。
PEG 患者普遍存在多种药物治疗的情况。鉴于 PPO 对健康结果没有影响，合理减少用药是合理的。
