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老年出院患者中开具与老年综合征相关药物的情况

The Prevalence of Prescribing Medications Associated with Geriatric Syndromes among Discharged Elderly Patients.

作者信息

Akkawi Muhammad Eid, Mohd Taufek Nor Hidayah, Abdul Hadi Azfar Diyana, Nik Lah Nik Nur Nadia Fatin

机构信息

Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia.

出版信息

J Pharm Bioallied Sci. 2020 Nov;12(Suppl 2):S747-S751. doi: 10.4103/jpbs.JPBS_305_19. Epub 2020 Nov 5.

Abstract

INTRODUCTION

A geriatric syndrome is a group of signs and symptoms that occur in older people and do not fit into a discrete disease. Several medications were reported to be associated with the incidence of geriatric syndromes.

OBJECTIVE

The objective of this study was to investigate the prevalence and pattern of medications associated with geriatric syndromes (MAGSs) among the discharged elderly patients (≥65 years old).

MATERIALS AND METHODS

This is a cross-sectional study that was conducted at a Malaysian teaching hospital from October to December 2018. The discharge medications of geriatric patients were reviewed to identify MAGSs using Beers criteria, Lexicomp drug information handbook, and the United States Food and Drug Administration (USFDA) drug inserts. Chi-square test was used to compare MAGS prescribed between categories. Spearman's rank-order correlation was used to test the correlation between the presence of MAGS and the number of discharge medications. A binomial logistic regression was applied to determine the predictors of prescribing MAGSs.

RESULTS

A total of 400 patients (mean ± standard deviation [SD] age, 72.0 ± 5.0 years) were included, and 45.3% of them were females. The most common diseases were hypertension followed by diabetes mellitus. The mean ± SD number of discharge medications per patient was 4.2 ± 2.5. The MAGSs were prescribed in 51.7% of the patients, and 54 patients were discharged with more than one MAGSs. The most commonly prescribed MAGSs were opioid analgesics, vasodilators, and β-blockers, which are associated with falls, depression, and delirium. Polypharmacy was found in 138 patients, and it was significantly associated with the presence of MAGSs ( < 0.001). No significant differences were found in prescribing MAGSs based on the patients' gender, race, and age.

CONCLUSION

The prescribing of MAGSs occurred in half of the discharged elderly patients. Physicians should be aware of the medications that are associated with special side effects in the elderly patients, and should switch to safer alternatives when possible.

摘要

引言

老年综合征是指发生在老年人身上的一组体征和症状,不属于某一种特定疾病。据报道,几种药物与老年综合征的发生有关。

目的

本研究的目的是调查出院老年患者(≥65岁)中与老年综合征相关的药物(MAGSs)的患病率和模式。

材料与方法

这是一项横断面研究,于2018年10月至12月在马来西亚一家教学医院进行。回顾老年患者的出院用药情况,使用Beers标准、Lexicomp药物信息手册和美国食品药品监督管理局(USFDA)药品说明书来确定MAGSs。采用卡方检验比较不同类别之间开具的MAGSs。使用Spearman等级相关检验来测试MAGSs的存在与出院用药数量之间的相关性。应用二项逻辑回归来确定开具MAGSs的预测因素。

结果

共纳入400例患者(平均±标准差[SD]年龄,72.0±5.0岁),其中45.3%为女性。最常见的疾病是高血压,其次是糖尿病。每位患者出院用药的平均±SD数量为4.2±2.5。51.7%的患者开具了MAGSs,54例患者出院时使用了不止一种MAGSs。最常开具的MAGSs是阿片类镇痛药、血管扩张剂和β受体阻滞剂,它们与跌倒、抑郁和谵妄有关。138例患者存在多重用药情况,且与MAGSs的存在显著相关(<0.001)。在根据患者性别、种族和年龄开具MAGSs方面未发现显著差异。

结论

一半的出院老年患者开具了MAGSs。医生应了解与老年患者特殊副作用相关的药物,并应尽可能改用更安全的替代药物。

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