Sheth Aakash Rajendra, Dave Ruchir B, Rana Devang, Sheth Diti
Department of Internal Medicine, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India.
Department of Internal Medicine, Sheth VS General Hospital, Ahmedabad, Gujarat, India.
Perspect Clin Res. 2020 Oct-Dec;11(4):144-149. doi: 10.4103/picr.PICR_144_18. Epub 2019 Apr 26.
Certain medications have higher chances of causing adverse effects in geriatric age group. Evidence is against prescribing these medications to the elderly. A list of such medications is called Beers criteria, which was revised by the American Geriatrics Society in 2015.
Using the Beer's list as reference, the researchers intend to find the extent and prevalence of potentially inappropriate medication (PIM) in geriatric population residing in different settings.
The researchers analyzed prescription pattern of 200 individuals with age ≥65 years, 100 individuals from old-age homes (OAHs) and 100 individuals from a tertiary care hospital. After collecting data, the researchers tallied each prescription with list of drugs in Beers criteria to find all the possible PIMs in both the groups.
It was found that the average age of residents of OAHs was significantly higher ( < 0.002) than the corresponding group from a tertiary care hospital. The residents of OAHs were also a receiving significantly higher ( < 0.0001) number of PIM than their counterparts from the tertiary care hospital. The average number of PIMs prescribed to females in OAHs was also significantly higher than those in the other group. About 55% of residents of OAHs received at least one PIM, compared to just 26% in the other group. At least 27% of individuals of OAHs received two or more PIMs, compared to just 2% in a tertiary care hospital. Lorazepam was the most commonly prescribed PIM in OAHs, whereas ranitidine was the most common PIM in a tertiary care hospital. Ibuprofen was the second most common PIM, with 15% of OAHs residents receiving this drug, while none of the patients from a tertiary care hospital received ibuprofen.
All the results point toward a poor prescription pattern in the residents of OAHs compared to those receiving care from a tertiary care hospital.
某些药物在老年人群体中产生不良反应的几率更高。有证据表明不应对老年人开具这些药物。此类药物清单被称为“比尔斯标准”，美国老年医学会于2015年对其进行了修订。
以比尔斯清单为参考，研究人员旨在找出居住在不同环境中的老年人群体中潜在不适当用药（PIM）的程度和流行情况。
研究人员分析了200名年龄≥65岁个体的处方模式，其中100名来自养老院（OAHs），100名来自三级护理医院。收集数据后，研究人员将每份处方与比尔斯标准中的药物清单进行核对，以找出两组中所有可能的PIM。
发现养老院居民的平均年龄显著高于三级护理医院的相应群体（<0.002）。养老院居民接受的PIM数量也显著高于三级护理医院的居民（<0.0001）。养老院中女性开具的PIM平均数量也显著高于另一组。约55%的养老院居民至少接受了一种PIM，而另一组中这一比例仅为26%。至少27%的养老院居民接受了两种或更多PIM，而在三级护理医院中这一比例仅为2%。劳拉西泮是养老院中最常开具的PIM，而雷尼替丁是三级护理医院中最常见的PIM。布洛芬是第二常见的PIM，15%的养老院居民服用了这种药物，而三级护理医院的患者中无人服用布洛芬。
所有结果都表明，与接受三级护理医院治疗的患者相比，养老院居民的处方模式较差。
