Malham Carmela Bou, Khatib Sarah El, Strumia Mathilde, Andrieu Sandrine, Cestac Philippe, Salameh Pascale
Aging Research Team, Center for Epidemiology and Research in POPulation health (CERPOP), Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France; Paul Sabatier University, Toulouse III, Toulouse F-31073, France.
Aging Research Team, Center for Epidemiology and Research in POPulation health (CERPOP), Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France; Paul Sabatier University, Toulouse III, Toulouse F-31073, France.
Arch Gerontol Geriatr. 2023 Jun;109:104947. doi: 10.1016/j.archger.2023.104947. Epub 2023 Jan 28.
The aim of this study was to identify the prevalence of potentially inappropriate drug prescribing (PIDP) using a combination of explicit and implicit criteria in a sample of Lebanese older adults taking 5 or more chronic medications per day in ambulatory care settings and to identify which factors were associated with PIDP. The explicit criteria included five different lists: Beers, Laroche, European Union (EU(7)-PIM list), STOPP/ START, STOPP Frail, and Alert and Mastering of Iatrogenesis issued by the French High Authority of Health. We also performed a sensitivity analysis to compare the potentially inappropriate medications according to each criterion.
Data were collected from each patient via a face-to-face interview. Logistic regressions were conducted to evaluate both objectives.
Many factors were positively associated with PIDP. The risk of PIDP was positively associated with age (OR =4.692, 95% CI [1.889-11.655]). Treatment for insomnia doubled the odds of PIDP (P<0.05). Participants who picked their medications from the pharmacy and had excess stock of drugs were at higher risk of having PIDP by 2.042 (95% CI [1.199-3.478]) and 2.965(95% CI [1.133-7.762]) respectively. However, patients with a perception of being heavily medicated and patients with a missed dose in the last two weeks had lower odds of PIDP.
Our study showed a high prevalence of PIDP in Lebanon, which is associated with various correlates. Selecting the appropriate tools to assess PIDP and providing patient education regarding the risks associated with potentially inappropriate medications are issues to be addressed among older adults.
本研究旨在通过明确和隐含标准相结合的方式，确定黎巴嫩门诊环境中每天服用5种或更多慢性药物的老年人样本中潜在不适当用药（PIDP）的患病率，并确定哪些因素与PIDP相关。明确标准包括五份不同清单：《Beers标准》、《Laroche标准》、欧盟（EU(7)-PIM清单）、《STOPP/START标准》、《STOPP衰弱标准》以及法国卫生高级管理局发布的《警惕与医源性疾病掌握标准》。我们还进行了敏感性分析，以根据每个标准比较潜在不适当药物。
通过面对面访谈收集每位患者的数据。进行逻辑回归以评估这两个目标。
许多因素与PIDP呈正相关。PIDP的风险与年龄呈正相关（OR = 4.692，95%置信区间[1.889 - 11.655]）。失眠治疗使PIDP的几率增加一倍（P<0.05）。从药房取药且有多余药品库存的参与者患PIDP的风险分别高2.042（95%置信区间[1.199 - 3.478]）和2.965（95%置信区间[1.133 - 7.762]）。然而，认为用药过量的患者和过去两周有漏服药物的患者患PIDP的几率较低。
我们的研究表明黎巴嫩PIDP的患病率很高，且与多种相关因素有关。选择合适的工具评估PIDP并就潜在不适当药物相关风险对患者进行教育，是老年人群体中需要解决的问题。
