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评估老年人潜在不适当心血管药物处方:土耳其全国性研究。

Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey.

机构信息

Department of Nuclear Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey; Integra Medical Imaging Center, Ankara, Turkey.

Department of Medical Pharmacology, Başakşehir Cam and Sakura City Hospital, İstanbul, Turkey.

出版信息

Anatol J Cardiol. 2023 Jun;27(6):328-338. doi: 10.14744/AnatolJCardiol.2023.2618.

Abstract

BACKGROUND

Elderly comprises a specific group due to possible alterations in the effects of drugs and comorbidities. We aimed to identify for the first time the characteristics and rates regarding the inappropriate prescriptions of cardiovascular system medications in the geriatric age group in Turkey.

METHODS

Cardiovascular system medications prescribed electronically by family physicians to patients aged 65 and over, in the years 2015 and 2016, were obtained through Prescription Information System administered by the Ministry of Health. Evaluation of potentially inappropriate prescriptions was done according to the 'Beers Criteria 2015 update.' Prescription rates for each group were evaluated under sub-breakdowns for the specialty of family physicians, gender, age groups, and 'Nomenclature of Territorial Units for Statistics' regions.

RESULTS

Approximately 65 million prescriptions were evaluated. The rate of potentially inappropriate cardiovascular medication prescribing was 0.33%. This raised to 11.56% when 'drugs to be used with caution' were included. It was observed that potentially inappropriate drugs have been prescribed more by specialist family physicians. The most frequently prescribed potentially inappropriate drugs were doxazosin in the diagnosis of hypertension and methyldopa regardless of indication. Diclofenac-warfarin was the most commonly prescribed concomitant drug use in the potentially clinically important drug-drug interactions group. The rate of potentially inappropriate drug prescribing was higher in males and in aged 80 years and older.

CONCLUSIONS

This pharmacoepidemiological study draws attention to potentially inappropriate cardiovascular system drugs prescribed in primary care settings to the elderly. The rate of potentially inappropriate cardiovascular system drug prescribed was found to be very low in Turkey.

摘要

背景

老年人由于药物作用和合并症的可能改变,构成了一个特定的群体。我们旨在首次确定土耳其老年人群中心血管系统药物不适当处方的特征和比率。

方法

通过卫生部管理的处方信息系统,获取了家庭医生在 2015 年和 2016 年为 65 岁及以上患者电子开具的心血管系统药物。根据“2015 年 Beers 标准更新”评估潜在不适当处方。根据家庭医生的专业、性别、年龄组和“统计领土单位命名法”区域,对每个组的处方率进行了细分。

结果

评估了大约 6500 万张处方。潜在不适当心血管药物处方率为 0.33%。当包括“谨慎使用的药物”时,这一比例上升到 11.56%。观察到,专科家庭医生更常开潜在不适当的药物。最常开的潜在不适当药物是用于治疗高血压的多沙唑嗪和无论有无指征均用的甲基多巴。在潜在具有临床重要药物相互作用的药物组中,最常开的同时使用的药物是双氯芬酸-华法林。潜在不适当药物处方率在男性和 80 岁及以上的人群中较高。

结论

这项药物流行病学研究引起了人们对初级保健环境中为老年人开处方的潜在不适当心血管系统药物的关注。在土耳其,潜在不适当心血管系统药物的处方率被发现非常低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46ca/10250774/efc28b00bfbf/ajc-27-6-328_f001.jpg

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