Faculty of Pharmacy, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania.
Research Centre for Pharmaco-Toxicological Evaluation, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania.
Int J Environ Res Public Health. 2021 Jul 1;18(13):7043. doi: 10.3390/ijerph18137043.
The European Commission's 2019 report regarding the state of health profiles highlighted the fact that Romania is among the countries with the lowest life expectancy in the European Union. Therefore, the objectives of the present study were to assess the current prescription habits of general physicians in Romania related to medicines taken by the elderly population for chronic conditions in both urban and rural setting and to discuss/compare these practices with the current international recommendations for the elderly (American-Beers 2019 criteria and European-STOPP/START v.2, 2015 criteria). A total of 2790 electronic prescriptions for chronic pathologies collected from 18 community pharmacies in the western part of Romania (urban and rural zones) were included. All medicines had been prescribed by general physicians. We identified the following situations of medicine overuse: 15% of the analyzed prescriptions involved the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for >2 weeks, 12% involved the use of a proton-pump inhibitor (PPI) for >8 weeks, theophylline was the bronchodilator used as a monotherapy in 3.17% of chronic obstructive pulmonary disease cases, and zopiclone was the hypnotic drug of choice for 2.31% of cases. Regarding the misuse of medicines, 2.33% of analyzed prescriptions contained an angiotensin-converting enzyme (ACE) inhibitor and an angiotensin II receptor blocker (ARB) for patients with renal failure in addition to vitamin K antagonists (AVKs) and NSAIDs in 0.43% of cases. Prescriptions for COX2 NSAIDs for periods longer than 2 weeks for patients with cardiovascular disorders accounted for 1.33% of prescriptions, and trihexyphenidyl was used as a monotherapy for patients with Parkinson's disease in 0.18% of cases. From the included medical prescriptions, 32.40% (the major percent of 2383 prescriptions) had two potentially inappropriate medications (PIMs). Rural zones were found to be risk factor for PIMs. Decreasing the chronic prescription of NSAIDs and PPIs, discontinuing the use of hypnotic drugs, and avoiding potentially harmful drug-drug associations will have long term beneficial effects for Romanian elderly patients.
欧盟委员会 2019 年关于健康状况的报告强调，罗马尼亚是欧盟预期寿命最低的国家之一。因此，本研究的目的是评估罗马尼亚全科医生目前在城市和农村地区为老年慢性病患者开具的药物处方习惯，并讨论/比较这些做法与当前国际上针对老年人的建议（2019 年美国 Beers 标准和 2015 年欧洲 STOPP/START v.2 标准）。共纳入了来自罗马尼亚西部（城市和农村地区）18 家社区药店的 2790 份慢性病电子处方。所有药物均由全科医生开具。我们发现了以下药物滥用情况：15%的分析处方中包含使用非甾体抗炎药（NSAIDs）超过 2 周，12%的处方中包含质子泵抑制剂（PPI）使用超过 8 周，茶碱被用作慢性阻塞性肺病患者的单药治疗，占 3.17%，佐匹克隆是催眠药物的首选，占 2.31%。关于药物误用，在肾功能衰竭患者中，除了维生素 K 拮抗剂（AVKs）和 NSAIDs 外，分析处方中有 0.43%包含血管紧张素转换酶（ACE）抑制剂和血管紧张素 II 受体阻滞剂（ARB）；在心血管疾病患者中，COX2 NSAIDs 的处方超过 2 周，占 1.33%，三己酚酯被用作帕金森病患者的单药治疗，占 0.18%。在所纳入的处方中，有 32.40%（2383 份处方中的主要部分）有两种潜在不适当的药物（PIMs）。农村地区是 PIMs 的危险因素。减少 NSAIDs 和 PPI 的慢性处方、停止使用催眠药物以及避免潜在的有害药物相互作用，将对罗马尼亚老年患者产生长期有益的影响。
