City Pharmacies Zagreb, Kralja Držislava 6, Zagreb, Croatia.
Faculty of Pharmacy and Biochemistry, Center for Applied Pharmacy, University of Zagreb, Ante Kovačića 1, 10 000, Zagreb, Croatia.
Sci Rep. 2024 Mar 14;14(1):6235. doi: 10.1038/s41598-024-56780-1.
Pharmacist's geriatric assessment can provide valuable insights into potential deprescribing targets, while including important information on various health-related domains. Data collected from a geriatric assessment questionnaire, for 388 patients, from the Croatian cohort of the EuroAgeism H2020 ESR 7 international project, along with guideline-based deprescribing criteria, were used to analyse potentially inappropriate prescribing of four medication groups (benzodiazepines (BZN), proton pump inhibitors (PPI), opioids, and non-steroidal anti-inflammatory drugs (NSAID)), and to assess the deprescribing potential. Binary logistic regression was used to explore the effects of age, gender, number of medicines and diagnoses, self-reported health, frailty score, and healthcare utilization on the likelihood of needing deprescribing. More than half of participants (n = 216, 55.2%) are candidates for deprescribing, with 31.1% of PPI, 74.8% of NSAID, 75% of opioid, and 96.1% of BZN users meeting at least one criterion. Most common criteria for deprescribing were inappropriately long use and safety concerns. Women (aOR = 2.58; p < 0.001), those reporting poor self-reported health (aOR = 5.14; p < 0.001), and those exposed to polypharmacy (aOR = 1.29; p < 0.001) had higher odds of needing to have medicines deprescribed. The high rate of deprescribing potential warrants prompt action to increase patient safety and decrease polypharmacy. Pharmacist's geriatric assessment and deprescribing-focused medication review could be used to lead a personalised approach.
药剂师的老年评估可以提供有价值的见解,了解潜在的撤药目标,同时包括各种与健康相关领域的重要信息。从克罗地亚 EuroAgeism H2020 ESR 7 国际项目的老年评估问卷中收集了 388 名患者的数据,以及基于指南的撤药标准,用于分析四类药物(苯二氮䓬类(BZN)、质子泵抑制剂(PPI)、阿片类药物和非甾体抗炎药(NSAID))的潜在不适当处方,并评估撤药潜力。二元逻辑回归用于探讨年龄、性别、药物和诊断数量、自我报告的健康状况、虚弱评分和医疗保健利用对需要撤药的可能性的影响。超过一半的参与者(n=216,55.2%)是撤药的候选者,31.1%的 PPI、74.8%的 NSAID、75%的阿片类药物和 96.1%的 BZN 使用者符合至少一个标准。最常见的撤药标准是使用不当时间过长和安全性问题。女性(aOR=2.58;p<0.001)、自我报告健康状况不佳的患者(aOR=5.14;p<0.001)和暴露于多种药物的患者(aOR=1.29;p<0.001)需要撤药的可能性更高。高撤药潜力率需要采取紧急行动,以提高患者安全性并减少多种药物的使用。药剂师的老年评估和以撤药为重点的药物审查可以用于个性化治疗。