Zhang Ying, Chen Zhaoyan, Tian Fangyuan
Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China.
Front Pharmacol. 2022 Sep 30;13:991087. doi: 10.3389/fphar.2022.991087. eCollection 2022.
Polypharmacy increases the prevalence of potentially inappropriate drugs potentially inappropriate medications among older persons, lowering their quality of life. PIMs use can lead to higher mortality in older patients. This study aimed to compare the prevalence of PIMs in older Chinese outpatients according to the Beers criteria and the Chinese criteria and to analyze the risk factors. Second, we describe the differences between the two criteria, focusing on the inappropriate prescription of drugs in older outpatients. In Chengdu, Southwest China, a cross-sectional study was undertaken using electronic medical data from 9 general hospitals s. Outpatients above the age of 60 who were treated in the Geriatrics Center of these medical institutions were included. The 2019 Beers criteria and the 2017 Chinese criteria were used to evaluate the PIM status of older outpatients, and binary logistic regression was used to identify potential risk factors for PIMs. There were 44,458 prescriptions from 2016 to 2018. The prevalence of PIMs among older outpatients was 30.05% (according to the Beers criteria) and 35.38% (according to the Chinese criteria), with statistical difference. Estazolam, hydrochlorothiazide and alprazolam were the top three PIMs in the Beers criteria, while the top three PIMs in the Chinese criteria were clopidogrel, estazolam and insulin. The prevalence of PIMs was associated with age, the number of diseases and the number of drugs. PIMs were shown to be more common in patients aged 70 and above, with more than 2 kinds of diseases and more than 4 kinds of drugs. PIMs were shown to be common among older outpatients in China, according to this study. The detection rate of the Chinese criteria was higher than that of the Beers criteria.
多重用药增加了老年人潜在不适当药物的流行率，降低了他们的生活质量。使用潜在不适当药物（PIMs）会导致老年患者死亡率升高。本研究旨在根据Beers标准和中国标准比较中国老年门诊患者中PIMs的流行率，并分析危险因素。其次，我们描述这两个标准之间的差异，重点关注老年门诊患者药物的不适当处方情况。在中国西南部的成都，利用9家综合医院的电子医疗数据进行了一项横断面研究。纳入在这些医疗机构老年医学中心接受治疗的60岁以上门诊患者。采用2019年Beers标准和2017年中国标准评估老年门诊患者的PIMs状态，并采用二元逻辑回归确定PIMs的潜在危险因素。2016年至2018年共有44458张处方。老年门诊患者中PIMs的流行率根据Beers标准为30.05%，根据中国标准为35.38%，存在统计学差异。艾司唑仑、氢氯噻嗪和阿普唑仑是Beers标准中排名前三的PIMs，而中国标准中排名前三的PIMs是氯吡格雷、艾司唑仑和胰岛素。PIMs的流行率与年龄、疾病数量和药物数量有关。PIMs在70岁及以上、患有2种以上疾病和使用4种以上药物的患者中更为常见。根据本研究，PIMs在中国老年门诊患者中很常见。中国标准的检出率高于Beers标准。
