Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany.
Psychogeriatrics. 2023 Mar;23(2):354-363. doi: 10.1111/psyg.12940. Epub 2023 Jan 31.
This study sought to investigate the frequency and characteristics of duplicate prescriptions (DPs) in elderly psychiatric inpatients using a novel categorisation of DPs that differentiates between appropriate duplicate prescriptions (ADPs) and potentially inappropriate duplicate prescriptions (PIDPs).
The study was conducted as a monocentric retrospective cross-sectional pilot study on the gerontopsychiatric ward of the Department of Psychiatry, Social Psychiatry and Psychotherapy of Hannover Medical School, a large university hospital in northern Germany. The outcome measures were the nature and frequency of PIDPs compared with the frequency of ADPs.
For 92 individual patients a total of 339 medication chart reviews were conducted between April 2021 and February 2022. The median age of the study population was 73 years (interquartile range (IQR) 68-82 years); 64.6% were female. Patients' medications comprised a median of eight drugs (IQR 6-11 drugs) and 43.1% of the study population were exposed to at least one PIDP (at least one grade-1 PIDP: 39.5%; at least one grade-2 PIDP: 5.0%; at least one grade-3 PIDP: 1.5%). Sedatives were most frequently responsible for grade-1 and grade-2 PIDPs, while grade-3 PIDPs were elicited exclusively by analgesics. Nearly half of the study population (49.0%) displayed at least one ADP.
Even though the clinical implications of PIDPs are not fully established to date, we recommend that physicians who treat elderly psychiatric patients pay special attention to PIDPs, especially PIDPs elicited by sedatives. Termination of PIDPs may prevent adverse drug reactions and save healthcare expenditures.
本研究旨在使用一种新的 DP 分类方法，即区分适当 DP (ADPs) 和潜在不适当 DP (PIDPs)，来调查老年精神科住院患者 DP 的频率和特征。
该研究是在德国北部一所大型大学附属医院汉诺威医学院精神病学、社会精神病学和心理治疗系的老年精神病病房进行的一项单中心回顾性横断面试点研究。主要转归为 PIDP 的性质和频率与 ADP 的频率相比。
2021 年 4 月至 2022 年 2 月，对 92 名个体患者共进行了 339 次药物图表审查。研究人群的中位年龄为 73 岁（四分位间距 68-82 岁）；64.6%为女性。患者的药物包括中位数 8 种药物（四分位间距 6-11 种药物），43.1%的研究人群至少使用一种 PIDP（至少一种 1 级 PIDP：39.5%；至少一种 2 级 PIDP：5.0%；至少一种 3 级 PIDP：1.5%）。镇静剂最常导致 1 级和 2 级 PIDP，而 3 级 PIDP 仅由镇痛药引起。近一半的研究人群（49.0%）至少有一种 ADP。
尽管迄今为止 PIDP 的临床意义尚未完全确定，但我们建议治疗老年精神科患者的医生特别注意 PIDP，尤其是由镇静剂引起的 PIDP。终止 PIDP 可能预防药物不良反应并节省医疗保健支出。
