老年精神病患者的药物不良反应——潜在不适当药物的影响
[Adverse Drug Reactions in Geriatric Psychiatric Patients - Influence of Potentially Inappropriate Drugs].
作者信息
Seifert Johanna, Fay Bianca, Strueven Nina Theresa, Schiekofer Stephan, Wenzel-Seifert Katharina, Haen Ekkehard
机构信息
Klinik für Psychiatrie und Psychotherapie, Bezirksklinikum Regensburg, Deutschland.
Klinik für Psychiatrie, Psychotherapie und Sozialpsychiatrie, Medizinische Hochschule Hannover, Deutschland.
出版信息
Psychiatr Prax. 2022 Jan;49(1):37-45. doi: 10.1055/a-1394-2412. Epub 2021 Mar 27.
OBJECTIVE
The purpose of this study was to examine the extent to which "potentially inappropriate drugs" (PID) are associated with an increased risk for adverse drug reactions (ADR).
METHODS
Data from 304 geriatric psychiatric inpatients was collected. Medical documentation was used to find indications of ADRs. Causal relationship between the ADR and the prescribed drugs was assessed by experts.
RESULTS
Almost 30 % of patients received ≥ 1 PID before admission to hospital, in comparison to 22 % at discharge. Increasing number of total prescriptions and the diagnosis of schizophrenia resulted in an increased risk for receiving ≥ 1 PID. Higher age and dementia were protective factors. Patients receiving ≥ 1 PID had a 5-fold increased risk of experiencing ≥ 1 ADR. Risk for an ADR increased with number of PID prescriptions. Patients treated with ≥ 1 PID had a 4-fold increased risk of experiencing severe ADRs. Risk for severe ADRs was 10-fold higher in patients treated with ≥ 2 PIDs.
CONCLUSION
The PRISCUS list predicts significant risk factors for the occurrence of ADRs in the geriatric psychiatric setting.
目的
本研究旨在探讨“潜在不适当药物”（PID）与药物不良反应（ADR）风险增加之间的关联程度。
方法
收集了304名老年精神科住院患者的数据。通过医疗记录查找ADR的迹象。由专家评估ADR与所开药物之间的因果关系。
结果
近30%的患者在入院前接受了≥1种PID，而出院时这一比例为22%。总处方数量增加以及精神分裂症的诊断导致接受≥1种PID的风险增加。年龄较大和患有痴呆症是保护因素。接受≥1种PID的患者发生≥1次ADR的风险增加了5倍。ADR的风险随着PID处方数量的增加而增加。接受≥1种PID治疗的患者发生严重ADR的风险增加了4倍。接受≥2种PID治疗的患者发生严重ADR的风险高出10倍。
结论
PRISCUS清单可预测老年精神科环境中ADR发生的重要风险因素。
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