评估土耳其社区药房老年患者潜在不适当药物使用和药物复杂性。
Evaluation of potentially inappropriate medications use and medication complexity in elderly patients applying to community pharmacy in Turkey.
机构信息
Department of Clinical Pharmacy, Faculty of Pharmacy, Suleyman Demirel University, Isparta, Turkey.
Faculty of Pharmacy, Suleyman Demirel University, Isparta, Turkey.
出版信息
BMC Geriatr. 2023 Oct 13;23(1):655. doi: 10.1186/s12877-023-04381-4.
BACKGROUND
Older adults often use multiple medicines to manage comorbidities well or to prevent associated complications. This study aims to determine polypharmacy, the use of potentially inappropriate medications (PIMs) using the 2019 Beers Criteria and to determine the Medication Regimen Complexity Index (MRCI) score. It also aims to identify factors associated with the presence of PIMs and the MRCI score.
METHODS
This cross-sectional study was carried out between 6 and 2023 and 5 May 2023 in a community pharmacy in Turkey. Elderly patients over 65 years of age, who used at least one drug, and who came to the pharmacy for any reason were included in the study. PIMs were determined according to the 2019 Beers Criteria. The Turkish validated version of the MRCI was used to determine the medication complexity score.
RESULTS
200 patients were included in this study. 59.5% of the patients were female and the median age was 70 (IQR, 66-74.75). Polypharmacy was detected in 33% of patients. The use of PIMs was determined in 63.5% of the patients. The median of the MRCI score was 11 (IQR, 7-15). The number of chronic diseases and drugs, presence of polypharmacy, MRCI score and mental disorders were found to be significantly higher in those with PIMs than in those without (p < 0.05). Having less than eight years of education, presence of polypharmacy, the presence of comorbidity (diabetes mellitus, cardiovascular disease, thyroid, chronic obstructive pulmonary disease (COPD), asthma and mental disorders) were associated with significantly higher MRCI scores (p < 0.05).
CONCLUSIONS
According to the results of our study, it was found that the elderly patients who came to the pharmacy had low MRCI scores, but had high PIMs use. Community pharmacists have an important role in identifying inappropriate drug use, so they should be trained to develop skills in identifying and reducing PIMs in older patients.
背景
老年人经常使用多种药物来很好地控制合并症或预防相关并发症。本研究旨在确定使用 2019 年 Beers 标准的多重用药，即潜在不适当药物（PIMs）的使用，并确定药物治疗方案复杂指数（MRCI）评分。它还旨在确定与 PIMs 和 MRCI 评分存在相关的因素。
方法
这项横断面研究于 2023 年 5 月 6 日至 2023 年 5 月 5 日在土耳其的一家社区药房进行。纳入标准为年龄在 65 岁以上、至少使用一种药物且因任何原因前往药房的老年患者。根据 2019 年 Beers 标准确定 PIMs。使用土耳其验证的 MRCI 版本来确定药物复杂性评分。
结果
本研究纳入了 200 名患者。其中 59.5%为女性，中位年龄为 70（IQR，66-74.75）。33%的患者存在多重用药。63.5%的患者使用了 PIMs。MRCI 评分的中位数为 11（IQR，7-15）。与无 PIMs 的患者相比，有 PIMs 的患者中慢性病和药物数量、多重用药、MRCI 评分和精神障碍的数量更高（p<0.05）。受教育程度低于 8 年、存在多重用药、存在合并症（糖尿病、心血管疾病、甲状腺疾病、慢性阻塞性肺疾病（COPD）、哮喘和精神障碍）与 MRCI 评分显著升高相关（p<0.05）。
结论
根据我们的研究结果，发现到药房就诊的老年患者的 MRCI 评分较低，但 PIMs 的使用率较高。社区药剂师在识别不适当的药物使用方面发挥着重要作用，因此应培训他们在识别和减少老年患者的 PIMs 方面的技能。
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