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社区居住的老年人中质子泵抑制剂的不当使用及其相关因素。

The inappropriate use of proton pump inhibitors and its associated factors among community-dwelling older adults.

作者信息

Rababa Mohammad, Rababa'h Abeer

机构信息

Departement of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, 22110, Jordan.

Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan.

出版信息

Heliyon. 2021 Jul 15;7(7):e07595. doi: 10.1016/j.heliyon.2021.e07595. eCollection 2021 Jul.

Abstract

OBJECTIVES

Little is known about the inappropriate use of proton pump inhibitors (PPIs) and how mild cognitive impairment (MCI) and high comorbid burden relate to the inappropriate prescribing of PPIs. Therefore, the current study aimed to examine these associations among community-dwelling older adults in Jordan.

METHOD

This cross-sectional study was conducted on 215 community-dwelling older adults from three local healthcare centers located in Irbid, Jordan. Data about PPI use, including the name of medication, dose, frequency, duration, and indication, were collected retrospectively from a review of the participating older adults' medication cards for November and December 2019. The collected data were evaluated based on the Food and Drug Administration (FDA) guidelines. MCI was measured using the Arabic version of the Montreal Cognitive Assessment, and comorbid burden was measured using the Cumulative Illness Rating Scale for Geriatrics.

RESULTS

Forty-seven percent of the participants were found to have taken a PPI, with 68 % having taken one for a longer period than recommended by the FDA. Older adults with MCI or high comorbid burden were found to be more susceptible than other older adults to the long-term use of PPIs. The logistic regression revealed that MCI is a statistically significant predictor of inappropriate PPI use (p < 0.001).

CONCLUSION

Inappropriate PPI use is common among community-dwelling older adults in Jordan, with a significantly higher prevalence of inappropriate PPI use in people with MCI than in people with normal cognitive abilities. Future intervention studies are highly recommended to encourage optimal prescribing of PPIs for community-dwelling older adults.

摘要

目的

关于质子泵抑制剂(PPI)的不当使用以及轻度认知障碍(MCI)和高共病负担如何与PPI的不当处方相关,目前所知甚少。因此,本研究旨在调查约旦社区居住的老年人中的这些关联。

方法

本横断面研究对来自约旦伊尔比德三个当地医疗中心的215名社区居住的老年人进行。关于PPI使用的数据,包括药物名称、剂量、频率、持续时间和适应症,通过回顾参与研究的老年人2019年11月和12月的药物卡片进行回顾性收集。收集的数据根据美国食品药品监督管理局(FDA)的指南进行评估。使用蒙特利尔认知评估的阿拉伯语版本测量MCI,使用老年累积疾病评定量表测量共病负担。

结果

发现47%的参与者服用过PPI,其中68%服用时间超过FDA推荐时间。发现患有MCI或高共病负担的老年人比其他老年人更容易长期使用PPI。逻辑回归显示,MCI是PPI不当使用的统计学显著预测因素(p < 0.001)。

结论

在约旦社区居住的老年人中,PPI的不当使用很常见,MCI患者中PPI不当使用的患病率显著高于认知能力正常的人。强烈建议未来进行干预研究,以鼓励为社区居住的老年人优化PPI处方。

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