Kobayashi Shotaro, Sugama Norio, Nagano Hiroyuki, Takahashi Masahiro, Kushiyama Akifumi
Department of Pharmacy, Sonoda Daiichi Hospital, Tokyo, Japan.
Department of Pharmacotherapy, Meiji Pharmaceutical University, Kiyose City, Japan.
Hosp Pract (1995). 2023 Apr;51(2):76-81. doi: 10.1080/21548331.2023.2173412. Epub 2023 Feb 8.
The purpose of this study was to investigate differences in the frequency of renally inappropriate medications (RIMs) in outpatient and inpatient among three institutions.
We collected prescription and renal function data for patients over 65 years of age from the drug department system. We selected 50 kinds of the most frequently used medicines which require dose adjustment according to a patient's renal function.
Outpatient RIM was seen in 611 cases (6.17%), and inpatient prescription RIM was seen in 317 cases (5.29%), showing a significant difference between the groups (odds ratio [OR] 1.18, 95% confidence interval [CI] 1.02-1.35). However, in a multivariate analysis, when the renal function was included, that difference between outpatients and inpatients became insignificant (OR 1.16, 95% CI 0.98-1.37). The distribution of prescription with or without RIM in outpatient and inpatient settings depended on the CKD stage. Outpatients with a better CKD stage (stage 1-3) had a higher rate of RIM than inpatients, while patients with a worse CKD stage (stage 4 or 5) had a higher rate of RIM than outpatients.
The rate of RIM in outpatients tends to be high, and attention should be paid to RIM in inpatients with a severe CKD stage.
本研究旨在调查三家机构门诊和住院患者中肾不适当用药（RIM）频率的差异。
我们从药房系统收集了65岁以上患者的处方和肾功能数据。我们选择了50种最常用的需要根据患者肾功能调整剂量的药物。
门诊患者中出现RIM的有611例（6.17%），住院患者处方中出现RIM的有317例（5.29%），两组之间存在显著差异（优势比[OR]1.18，95%置信区间[CI]1.02 - 1.35）。然而，在多变量分析中，纳入肾功能因素后，门诊患者和住院患者之间的差异变得不显著（OR 1.1
