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日本一家三级紧急医疗机构老年患者出院时潜在不适当用药情况:一项回顾性横断面观察研究。

Potentially inappropriate medications at discharge among elderly patients at a single tertiary emergency medical institution in Japan: a retrospective cross-sectional observational study.

作者信息

Aida Kenta, Azuma Kazunari, Mishima Shiro, Ishii Yuri, Suzuki Shoji, Oda Jun

机构信息

Department of Emergency and Critical Care Medicine Tokyo Medical University Tokyo Japan.

Department of Medical Safety Management Tokyo Medical University Tokyo Japan.

出版信息

Acute Med Surg. 2021 Nov 29;8(1):e711. doi: 10.1002/ams2.711. eCollection 2021 Jan-Dec.

Abstract

AIM

Potentially inappropriate medications (PIMs) are associated with a lower medication adherence and a higher incidence of adverse events and medical costs among elderly patients. The current study aimed to examine the prescription status of elderly patients transported to tertiary emergency medical institutions to compare the proportion of elderly patients using PIMs at admission and discharge and to investigate the characteristics of PIMs at discharge and their associated factors.

METHODS

In total, 264 patients aged 75 years or older who were transferred to and discharged from the emergency room at Tokyo Medical University Hospital, a tertiary care hospital, from September 2018 to August 2019 were included in this study. We quantified the number of PIMs at admission and discharge based on the Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP) criteria version 2. The primary outcomes were the proportion of elderly patients taking at least one PIM at admission and discharge.

RESULTS

The proportions of patients taking PIMs at admission and discharge were 55% ( = 175) and 28% ( = 74), respectively. Old age, greater number of PIMs at admission, and greater number of medications at discharge were directly associated with PIMs at discharge.

CONCLUSIONS

Admission to tertiary care hospitals resulted in a lower number of prescribed PIMs. Elderly patients with a higher number of PIMs at admission and higher number of medications at discharge might have been prescribed with PIMs.

摘要

目的

潜在不适当用药(PIMs)与老年患者较低的用药依从性、较高的不良事件发生率及医疗费用相关。本研究旨在调查转诊至三级急诊医疗机构的老年患者的处方情况,比较入院时和出院时使用PIMs的老年患者比例,并探究出院时PIMs的特征及其相关因素。

方法

本研究纳入了2018年9月至2019年8月期间转诊至东京医科大学医院急诊科并出院的264例75岁及以上的患者,该医院为三级医疗机构。我们根据老年人潜在不适当处方筛查工具(STOPP)标准第2版对入院时和出院时的PIMs数量进行量化。主要结局指标为入院时和出院时服用至少一种PIM的老年患者比例。

结果

入院时和出院时服用PIMs的患者比例分别为55%(n = 175)和28%(n = 74)。高龄、入院时PIMs数量较多以及出院时用药数量较多与出院时的PIMs直接相关。

结论

入住三级医疗机构导致开具的PIMs数量减少。入院时PIMs数量较多且出院时用药数量较多的老年患者可能曾被开具PIMs。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd20/8628299/8147ff15b315/AMS2-8-e711-g002.jpg

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