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社区居住老年人潜在不适当用药情况:使用国际老年流动研究的纵向分析

Potentially inappropriate medication on communitydwelling older adults: Longitudinal analysis using the International Mobility in Aging Study.

作者信息

Pineda Edison, Fernández Alejandra, Curcio Carmen Lucía, Fernandes de Souza Juliana, Vafaei Afshin, Gómez José Fernando

机构信息

Facultad de Ciencias para la Salud, Universidad de Caldas, Manizales, Colombia; Grupo de Investigación en Gerontología y Geriatría, Facultad de Ciencias para la Salud, Universidad de Caldas, Manizales, Colombia.

Hospital Alma Mater de Antioquia, Medellín, Colombia.

出版信息

Biomedica. 2024 May 30;44(2):207-216. doi: 10.7705/biomedica.6992.

Abstract

INTRODUCTION

Medications are a fundamental part of the treatment of multiple pathologies. However, despite their benefits, some are considered potentially inappropriate medications for older people given their safety profile. Epidemiological data differences related to potentially inappropriate medications make it difficult to determine their effects on elderly people.

OBJECTIVE

To estimate the prevalence and types of potentially inappropriate medications using the 2019 Beers Criteria® in a cohort of adults older than 65 years.

MATERIALS AND METHODS

We performed an observational, multicenter, retrospective, longitudinal study of a four-year follow-up of potentially inappropriate medications in community-dwelling older adults.

RESULTS

We followed 820 participants from five cities for four years (2012-2016) and evaluated them in three different moments (m1 = 2012, m2 = 2014, and m3 = 2016). The average age was 69.07 years, and 50.9% were women. The potentially inappropriate medication prevalence in the participants was 40.24%. The potentially inappropriate medications' mean among the studied subjects in the first moment was 1.65 (SD = 0.963), in the second was 1.73 (SD = 1.032), and in the third was 1.62 (SD = 0.915). There were no statistical differences between measurements (Friedman test, value = 0.204). The most frequent potentially inappropriate medications categories were gastrointestinal (39.4%), analgesics (18.8%), delirium-related drugs (15.4%), benzodiazepines (15.2%), and cardiovascular (14.2%).

CONCLUSIONS

About half of the population of the community-dwelling older adults had prescriptions of potentially inappropriate medications in a sustained manner and without significant variability over time. Mainly potentially inappropriate medications were gastrointestinal and cardiovascular drugs, analgesics, delirium-related drugs, and benzodiazepines.

摘要

引言

药物是多种疾病治疗的基本组成部分。然而,尽管它们有诸多益处,但鉴于其安全性,一些药物被认为对老年人可能是潜在不适当的药物。与潜在不适当药物相关的流行病学数据差异使得难以确定其对老年人的影响。

目的

使用2019年版《美国老年医学会Beers标准》评估65岁以上成年人群中潜在不适当药物的患病率和类型。

材料与方法

我们对社区居住的老年人中潜在不适当药物进行了一项观察性、多中心、回顾性、为期四年随访的纵向研究。

结果

我们对来自五个城市的820名参与者进行了四年(2012 - 2016年)的随访,并在三个不同时间点(m1 = 2012年,m2 = 2014年,m3 = 2016年)对他们进行评估。平均年龄为69.07岁,女性占50.9%。参与者中潜在不适当药物的患病率为40.24%。在研究对象中,第一个时间点潜在不适当药物的均值为1.65(标准差 = 0.963),第二个时间点为1.73(标准差 = 1.032),第三个时间点为1.62(标准差 = 0.915)。各测量值之间无统计学差异(Friedman检验,值 = 0.204)。最常见的潜在不适当药物类别是胃肠道药物(39.4%)、镇痛药(18.8%)、与谵妄相关的药物(15.4%)、苯二氮䓬类药物(15.2%)和心血管药物(14.2%)。

结论

社区居住的老年人中约有一半持续开具了潜在不适当药物的处方,且随时间无显著变化。主要的潜在不适当药物是胃肠道和心血管药物、镇痛药、与谵妄相关的药物以及苯二氮䓬类药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07c1/11314927/07fec6b9bc87/2590-7379-bio-44-02-6992-gf1.jpg

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