IRCCS MultiMedica, Sesto S. Giovanni, 20099 Milan, Italy.
Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy.
Int J Environ Res Public Health. 2022 Mar 18;19(6):3612. doi: 10.3390/ijerph19063612.
Pharmacological intervention is one of the cornerstones in the treatment and prevention of disease in modern healthcare. However, a large number of drugs are often prescribed and used inappropriately, especially in elderly patients. We aimed at investigating the annual prevalence of potentially inappropriate prescriptions (PIPs) among older outpatients using administrative healthcare databases of the Piedmont Region (Italy) over a seven-year period (2012-2018). We included all Piedmont outpatients aged 65 years or older with at least one drug prescription per year. Polypharmacy and the prevalence of PIPs according to the ERD list explicit tool were measured on an annual basis. A range between 976,398 (in 2012) and 1,066,389 (in 2018) elderly were evaluated. Among them, the number of subjects with at least one PIP decreased from 418,537 in 2012 to 339,764 in 2018; the prevalence significantly reduced by ~25% over the study period. The stratified analyses by age groups and sex also confirmed the downward trend and identified several differences in the most prevalent inappropriately prescribed drugs. Overall, despite a reduction in PIP prevalence, one out of three older outpatients was still exposed to inappropriateness, highlighting the extensive need for intervention to improve prescribing.
药物干预是现代医疗保健中治疗和预防疾病的基石之一。然而，大量药物经常被不适当地开具和使用，尤其是在老年患者中。我们旨在使用意大利皮埃蒙特大区（Piedmont Region）的医疗保健管理数据库，在七年期间（2012-2018 年）调查老年门诊患者中潜在不适当处方（PIP）的年度流行率。我们纳入了每年至少有一份药物处方的所有 65 岁或以上的皮埃蒙特门诊患者。每年测量多药治疗和根据 ERD 清单明确工具的 PIP 流行率。评估了 976398 名（2012 年）至 1066389 名（2018 年）老年人。其中，至少有一种 PIP 的患者人数从 2012 年的 418537 例减少到 2018 年的 339764 例；在研究期间，流行率显著降低了约 25%。按年龄组和性别分层分析也证实了这一下降趋势，并确定了最常见不适当处方药物的几个差异。总体而言，尽管 PIP 流行率有所降低，但三分之一的老年门诊患者仍面临不适当用药的问题，突出表明需要广泛干预以改善处方。
