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老年住院患者潜在不适当用药情况及其相关因素:一项基于Beers标准的横断面研究

Prevalence of potentially inappropriate medication and its correlates in elderly hospitalized patients: A cross-sectional study based on Beers criteria.

作者信息

Sharma Rishabh, Bansal Parveen, Garg Ravinder, Ranjan Ravi, Kumar Rakesh, Arora Malika

机构信息

Department of Pharmacy Practice, ISF College of Pharmacy, Moga, India.

University Centre of Excellence in Research, Baba Farid University of Health Sciences, Lucknow, Uttar Pradesh, India.

出版信息

J Family Community Med. 2020 Sep-Dec;27(3):200-207. doi: 10.4103/jfcm.JFCM_175_20. Epub 2020 Sep 25.

Abstract

BACKGROUND

The increase in the prescription of potentially inappropriate medication (PIM) in older adults with significant health consequences is a global concern. This study aimed to determine the prevalence of PIM prescription in older adults as identified by Beers criteria 2015 and 2019.

MATERIALS AND METHODS

A cross-sectional study was carried out in older adults aged >65 years at a tertiary care postgraduate teaching hospital. All patients aged ≥65 years irrespective of their gender, admitted in the medical ward of the hospital with single/multiple comorbidities, and prescribed at least one daily medication, were included in the study. Data of patient history, patient case sheet, medication charts, laboratory reports, as well as radiological examinations test reports were retrieved from their files and were captured in a prevalidated data collection form. SPSS used for data analysis; multivariate logistic regression was used to determine the predictors of PIM prescribing and odds ratios (ORs) and 95% confidence intervals for ORs were computed.

RESULTS

Study included 323 patients; 61.3% were male, 74% patients were 65-70 years of age, and 78% patients were illiterate. The overall prevalence of PIM uses according to the Beers criteria 2015 and 2019 was 60.1% and 61.9%, respectively. No association found between PIMs prescribes and diagnosis category. Male gender, age 76-80 years, and education 10-12th class were found to be significantly related to PIM prescription.

CONCLUSION

This study reflects a critical view of noncompliance of Beers criteria for geriatric healthcare even in tertiary care hospitals in India. Creatinine clearance rate should be kept in view when prescribing medicines for elderly inpatients.

摘要

背景

老年人中潜在不适当用药(PIM)处方增加且会产生严重健康后果,这是一个全球关注的问题。本研究旨在确定根据2015年和2019年《Beers标准》确定的老年人中PIM处方的患病率。

材料与方法

在一家三级护理研究生教学医院对65岁以上的老年人进行了一项横断面研究。纳入所有年龄≥65岁、无论性别、因单一或多种合并症入住医院内科病房且每天至少开具一种药物处方的患者。从他们的病历中检索患者病史、患者病历表、用药记录、实验室报告以及放射学检查报告的数据,并记录在预先验证的数据收集表中。使用SPSS进行数据分析;采用多因素逻辑回归确定PIM处方的预测因素,并计算比值比(OR)和OR的95%置信区间。

结果

研究纳入323例患者;61.3%为男性,74%的患者年龄在65 - 70岁之间,78%的患者为文盲。根据2015年和2019年《Beers标准》,PIM使用的总体患病率分别为60.1%和61.9%。未发现PIM处方与诊断类别之间存在关联。发现男性、年龄76 - 80岁以及教育程度为10 - 12年级与PIM处方显著相关。

结论

本研究反映了即使在印度的三级护理医院中,老年医疗保健也未遵守《Beers标准》这一严峻情况。为老年住院患者开药时应考虑肌酐清除率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5597/7745783/12824c2f5790/JFCM-27-200-g001.jpg

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