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中国社区中老年糖尿病患者潜在不适当用药情况。

Potentially Inappropriate Medication Use Among Older Patients with Diabetes in a Chinese Community.

机构信息

The Second Outpatient Department, Peking University Third Hospital, Beijing China.

Department of Pharmacy, Peking University Third Hospital, Beijing, China.

出版信息

Exp Clin Endocrinol Diabetes. 2023 Oct;131(10):548-553. doi: 10.1055/a-2123-0734. Epub 2023 Jul 4.

Abstract

BACKGROUND

Potentially inappropriate medications (PIMs) are frequently prescribed to older people with diabetes. This study aimed to assess the prevalence of PIM use in older people with diabetes and identify potential risk factors influencing the development of PIM use.

METHODS

This was a cross-sectional study conducted in an outpatient setting in Beijing, China, using Chinese criteria. The prevalence of PIM use, polypharmacy, and comorbidities in older adults with diabetes in an outpatient setting was measured. Logistic models were employed to investigate the association among polypharmacy, comorbidities, and PIM use.

RESULTS

The prevalence of PIM use and polypharmacy was 50.1% and 70.8%, respectively. The most common comorbidities were hypertension (68.0%), hyperlipemia (56.6%), and stroke (36.3%), and the top three inappropriately used medications were insulin (22.0%), clopidogrel (11.9%), and eszopiclone (9.81%). Age (OR 1.025; 95% CI 1.009, 1.042), the number of diagnoses (OR 1.172; 95% CI 1.114, 1.232), coronary heart disease (OR 1.557; 95% CI 1.207, 2.009), and polypharmacy (OR 1.697; 95% CI 1.252, 2.301) were associated with PIM use.

CONCLUSIONS

Given the higher rate of PIM use among older adults with diabetes, strategies and interventions targeting this population are needed to minimize PIM use.

摘要

背景

患有糖尿病的老年人经常被开具潜在不适当药物(PIMs)。本研究旨在评估患有糖尿病的老年人中 PIM 使用的流行率,并确定影响 PIM 使用发展的潜在危险因素。

方法

这是一项在中国北京的门诊环境中进行的横断面研究,使用中国标准。测量了在门诊环境中患有糖尿病的老年人中 PIM 使用、多药治疗和合并症的流行率。使用逻辑模型调查了多药治疗、合并症与 PIM 使用之间的关联。

结果

PIM 使用和多药治疗的流行率分别为 50.1%和 70.8%。最常见的合并症是高血压(68.0%)、高脂血症(56.6%)和中风(36.3%),最不适当使用的三种药物是胰岛素(22.0%)、氯吡格雷(11.9%)和唑吡坦(9.81%)。年龄(OR 1.025;95% CI 1.009, 1.042)、诊断数量(OR 1.172;95% CI 1.114, 1.232)、冠心病(OR 1.557;95% CI 1.207, 2.009)和多药治疗(OR 1.697;95% CI 1.252, 2.301)与 PIM 使用相关。

结论

鉴于患有糖尿病的老年人中 PIM 使用率较高,需要针对这一人群制定策略和干预措施,以尽量减少 PIM 使用。

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