[养老院居民潜在不适当用药情况：基于2017年全国索赔数据（AOK）的风险因素分析]
[Potentially Inappropriate Medication of Nursing Home Residents: An Analysis of Risk Factors Based on National Claims Data (AOK) for 2017].
作者信息
Weinand Sina, Thürmann Petra A, Dröge Patrik, Koetsenruijter Jan, Klora Mike, Grobe Thomas G
机构信息
Gesundheitsberichterstattung und Biometrie, aQua - Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen, Deutschland.
Abteilung Allgemeinmedizin und Versorgungsforschung, UniversitätsKlinikum Heidelberg, Heidelberg, Deutschland.
出版信息
Gesundheitswesen. 2022 May;84(5):448-456. doi: 10.1055/a-1335-4512. Epub 2021 Mar 5.
AIM OF THE STUDY
The aim of this study was to assess risk factors for prescription of potentially inappropriate medication (PIM) to nursing home residents using the PRISCUS list in 2017.
METHODS
Using claims data (AOK) we analysed insured nursing home residents aged 65 or older in 2017. The PRISCUS list was used to identify PIMs. A multivariate logistic regression analysis was performed to analyse risk factors.
RESULTS
The study population in 2017 included 259 328 nursing home residents, out of them 25.5% received at least one potentially inappropriate medication (women: 25.6%/men: 24.9%). Female and younger aged nursing home residents had a higher risk for at least one PRISCUS prescription. Polypharmacy, an increasing number of attending physicians, and hospital stays were additional risk factors for a PRISCUS prescription. Furthermore, regional (Bundesland) variations contributed to differences in PRISCUS prescriptions.
CONCLUSION
The frequent PIM prescriptions in nursing home residents are a relevant topic regarding drug therapy safety. Regional differences, which cannot be explained by nursing home resident characteristics, show options for modifications and the need for further research.
研究目的
本研究旨在评估2017年使用PRISCUS清单给养老院居民开具潜在不适当药物（PIM）处方的风险因素。
方法
利用索赔数据（AOK），我们分析了2017年65岁及以上参保养老院居民的情况。使用PRISCUS清单识别PIM。进行多因素逻辑回归分析以分析风险因素。
结果
2017年的研究人群包括259328名养老院居民，其中25.5%接受了至少一种潜在不适当药物（女性：25.6%/男性：24.9%）。女性和年龄较小的养老院居民接受至少一种PRISCUS处方的风险更高。多种药物治疗、主治医生数量增加和住院是PRISCUS处方的其他风险因素。此外，地区（联邦州）差异导致了PRISCUS处方的不同。
结论
养老院居民中频繁开具PIM处方是药物治疗安全方面的一个重要问题。无法用养老院居民特征解释的地区差异显示了改进的方向以及进一步研究的必要性。
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