Department of Pharmacy, The First Hospital of Jilin University, Changchun, China.
Medicine (Baltimore). 2021 Oct 22;100(42):e27494. doi: 10.1097/MD.0000000000027494.
The aging of the population has become a worldwide concern, especially in China. Polypharmacy and potentially inappropriate medications (PIMs) are prominent issues in elderly patients. Therefore, the aim of this study was to investigate the prevalence of polypharmacy and PIMs in older inpatients and further to explore the factors associated with PIM use.A retrospective, single-center, cross-sectional study was conducted. A total of 1200 inpatients aged 65 years or older admitted from January 2015 to December 2015 were included. The prevalence of polypharmacy (5-9 medications) and hyperpolypharmacy (10 or more medications) was calculated. The 2019 American Geriatric Society Beers criteria were applied to assess PIMs use. Multivariate logistic regression was used to determine the independent factors of PIM use, while zero-inflated negative binomial regression was performed to evaluate the relationship between polypharmacy and PIM use.The median age of the study population was 76 years (interquartile range = 71-81). The median number of medications was 9 (interquartile range = 7-12). 91.58% of the patients took 5 or more medications simultaneously, and 30.08% of the patients were subjected to one or more PIMs. Spironolactone, furosemide, and zopiclone were the top 3 most frequently encountered PIMs. Hyperpolypharmacy and older age were identified as independent factors associated with PIM use. The risk of PIMs rises with the number of medications prescribed.Polypharmacy and PIM use were common in our study, and the risk of PIM use correlated with an increase in the number of medications already prescribed.
人口老龄化已成为一个全球性问题,尤其是在中国。老年人普遍存在多重用药和潜在不适当用药(PIMs)的问题。因此,本研究旨在调查老年住院患者多重用药和 PIMs 的流行情况,并进一步探讨与 PIM 使用相关的因素。
本研究采用回顾性、单中心、横断面研究方法。共纳入 2015 年 1 月至 2015 年 12 月期间收治的 1200 名年龄在 65 岁及以上的住院患者。计算了 5-9 种药物和 10 种及以上药物的多重用药(polypharmacy)和超多重用药(hyperpolypharmacy)的患病率。应用 2019 年美国老年学会 Beers 标准评估 PIMs 的使用情况。采用多变量逻辑回归确定 PIM 使用的独立因素,采用零膨胀负二项回归评估多重用药与 PIM 使用之间的关系。
研究人群的中位年龄为 76 岁(四分位间距[IQR]:71-81)。中位用药数为 9 种(IQR:7-12)。91.58%的患者同时服用 5 种或 5 种以上药物,30.08%的患者使用 1 种或 1 种以上 PIMs。螺内酯、呋塞米和佐匹克隆是最常见的前 3 种 PIMs。超多重用药和年龄较大是与 PIM 使用相关的独立因素。随着处方药物数量的增加,PIMs 的风险增加。
本研究中,多重用药和 PIMs 的使用较为普遍,PIMs 的使用风险与已处方药物数量的增加相关。