Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Department of Neurology, Hannover Medical School, Hannover, Germany.
J Neural Transm (Vienna). 2022 Nov;129(11):1367-1375. doi: 10.1007/s00702-022-02541-1. Epub 2022 Sep 2.
Adverse drug reactions (ADRs) constitute a frequent cause of hospitalization in older people. The risk of ADRs is increased by the prescription of potentially inappropriate medications for older people (PIMs). The PRISCUS list and the FORTA classification represent established tools to detect PIMs. The aim of the present study was to examine the prevalence and characteristics of PIM prescriptions on the gerontopsychiatric ward of a university hospital in Germany. To this aim, medication charts of 92 patients (mean age 75.9 ± 7.7 years; 66.3% female) were analyzed on a weekly basis until patient discharge by utilization of the PRISCUS list and the FORTA classification. Overall, 335 medication reviews comprising 2363 drug prescriptions were analyzed. 3.0% of the prescribed drugs were PIMs according to the PRISCUS list, with benzodiazepines and Z-drugs accounting for nearly half (49.3%) of all PIM prescriptions. 30.4% of the patients were prescribed at least one PRISCUS-PIM, while 43.5% of the study population took at least one FORTA class D drug. A considerable proportion of gerontopsychiatric patients were affected by PIMs; however, the overall number of PIM prescriptions in the study population was low. Further improvements in the quality of prescribing should target the use of sedating agents such as benzodiazepines and Z-drugs. Physicians should be aware of discrepancies between the PRISCUS list and the FORTA classification.
药物不良反应(ADR)是老年人住院的常见原因。老年人潜在不适当药物(PIM)的处方会增加 ADR 的风险。PRISCUS 清单和 FORTA 分类是检测 PIM 的既定工具。本研究旨在检查德国一所大学医院老年精神科病房 PIM 处方的流行率和特征。为此,每周利用 PRISCUS 清单和 FORTA 分类分析 92 名患者(平均年龄 75.9±7.7 岁;66.3%为女性)的用药图表,直至患者出院。总共分析了 335 次药物评估,包括 2363 种药物处方。根据 PRISCUS 清单,处方中 3.0%的药物为 PIM,其中苯二氮䓬类和 Z 类药物几乎占所有 PIM 处方的一半(49.3%)。30.4%的患者至少开了一种 PRISCUS-PIM,而 43.5%的研究人群至少开了一种 FORTA 类 D 药物。相当一部分老年精神科患者受到 PIM 的影响;然而,研究人群中 PIM 处方的总数较低。进一步提高处方质量应针对使用苯二氮䓬类和 Z 类等镇静剂。医生应注意 PRISCUS 清单和 FORTA 分类之间的差异。