Sipos Mariana, Farcas Andreea, Leucuta Daniel Corneliu, Bulik Noémi-Beátrix, Huruba Madalina, Dumitrascu Dan, Mogosan Cristina
Department of Pharmacology, Physiology and Physiopathology, Faculty of Pharmacy, "Iuliu Haţieganu" University of Medicine and Pharmacy, 400010 Cluj-Napoca, Romania.
Pharmacovigilance Research Center, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania.
Pharmaceuticals (Basel). 2023 Jun 7;16(6):852. doi: 10.3390/ph16060852.
Pharmacokinetic and pharmacodynamic changes associated with old age, along with multimorbidity and polypharmacy might lead to inappropriate prescribing and adverse reactions. Explicit criteria such as the Screening tool of older people's prescribing (STOPP) are useful to identify potential inappropriate prescribing's (PIPs). Our retrospective study included discharge papers from patients aged ≥65 years, from an internal medicine department in Romania (January-June 2018). A subset of the STOPP-2 criteria was used to assess the prevalence and characteristics of PIPs. Regression analysis was performed to evaluate the impact of associated risk factors (i.e., age, gender, polypharmacy and specific disease). Out of the 516 discharge papers analyzed, 417 were further assessed for PIPs. Patients' mean age was 75 years, 61.63% were female and 55.16% had at least one PIP, with 81.30% having one or two PIPs. Antithrombotic agents in patients with significant bleeding risk was the most prevalent PIP (23.98%), followed by the use of benzodiazepines (9.11%). Polypharmacy, extreme (>10 drugs) polypharmacy, hypertension and congestive heart failure were found as independent risk factors. PIP was prevalent and increased with (extreme) polypharmacy and specific cardiac disease. Comprehensive criteria like STOPP should be regularly used in clinical practice to identify PIPs to prevent potential harm.
与老年相关的药代动力学和药效学变化，以及多种疾病并存和多种药物联合使用可能导致不适当的处方和不良反应。明确的标准，如老年人处方筛查工具（STOPP），有助于识别潜在的不适当处方（PIPs）。我们的回顾性研究纳入了罗马尼亚某内科部门（2018年1月至6月）年龄≥65岁患者的出院病历。使用STOPP-2标准的一个子集来评估PIPs的患病率和特征。进行回归分析以评估相关风险因素（即年龄、性别、多种药物联合使用和特定疾病）的影响。在分析的516份出院病历中，417份进一步评估了PIPs。患者的平均年龄为75岁，61.63%为女性，55.16%至少有一项PIP，其中81.30%有一至两项PIP。有显著出血风险患者使用抗血栓药物是最常见的PIP（23.98%），其次是使用苯二氮䓬类药物（9.11%）。多种药物联合使用、极端（>10种药物）多种药物联合使用、高血压和充血性心力衰竭被发现为独立风险因素。PIP很普遍，且随着（极端）多种药物联合使用和特定心脏病而增加。像STOPP这样的综合标准应在临床实践中定期使用，以识别PIPs，防止潜在危害。
