Epidemiology Department, Hospital de la Santa Creu i Sant Pau, IR Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
BMC Geriatr. 2024 Sep 30;24(1):798. doi: 10.1186/s12877-024-05308-3.
In recent years, the need for a more appropriate prescription of medications in the older population has emerged as a significant public health concern. In this study, we aimed to evaluate the prevalence of potentially inappropriate medications (PIM) in hospitalized adults aged ≥ 75.
This was a retrospective descriptive observational study of patients at 16 hospitals in Spain. The study population included inpatients aged ≥ 75 admitted during a 7-day period (May 10 to 16, 2021). Data were obtained from the pharmacy databases of the participating hospitals. The list of PIMs was based on the Beers, STOPP-START, EU-PIM and PRISCUS criteria.
A total of 4,183 patients were included. PIMs were detected in 23.5% (N = 1,126) of the cohort. The prevalence rates at the participating hospitals ranged from 10% to 42.5%. The PIM/patient ratio was 1.2. The most common PIMs were midazolam, dexketoprofen, diazepam, and doxazosin, all of which (except for doxazosin) were more common in women. Benzodiazepines accounted for 70% of all PIMs. In 35% of cases, the PIMs were initiated before hospital admission. Of the 818 PIMs initiated during hospitalization, the two most common were benzodiazepines (49%) and anti-inflammatory drugs (25%). At discharge, only 4.9% of the PIMs initiated during the hospital stay were still prescribed.
In this population of older hospitalized patients, the overall prevalence of PIMs was moderate. However, the prevalence rate at the participating hospitals was highly variable. In most cases, PIMs prescribed prior to hospitalization for chronic conditions were not withdrawn during the hospital stay. No significant increase in PIMs was observed from pre-admission to post-discharge. These findings underscore the need for multidisciplinary interventions to optimize the pharmaceutical treatment in older adults in the hospital setting to reduce the consequences of PIMs in patients.
近年来，老年人用药的合理性已成为一个重要的公共卫生问题。本研究旨在评估 75 岁及以上住院患者中潜在不适当用药（PIM）的流行情况。
这是一项在西班牙 16 家医院进行的回顾性描述性观察性研究。研究人群包括在 2021 年 5 月 10 日至 16 日期间住院的 75 岁及以上患者。数据来自参与医院的药房数据库。PIM 清单基于 Beers、STOPP-START、EU-PIM 和 PRISCUS 标准。
共纳入 4183 名患者。队列中有 23.5%（N=1126）的患者发现 PIM。各参与医院的流行率在 10%至 42.5%之间。每位患者的 PIM 数量为 1.2。最常见的 PIM 是咪达唑仑、右旋酮洛芬、地西泮和多沙唑嗪，除多沙唑嗪外，这些药物在女性中更为常见。苯二氮䓬类药物占所有 PIM 的 70%。35%的 PIM 在入院前开始使用。在住院期间开始使用的 818 种 PIM 中，最常见的两种是苯二氮䓬类药物（49%）和抗炎药（25%）。出院时，住院期间开始使用的 PIM 中只有 4.9%仍在开具。
在这一老年住院患者人群中，总体 PIM 流行率处于中等水平。然而，参与医院的流行率差异很大。在大多数情况下，对于慢性疾病在入院前开具的 PIM，在住院期间并未停用。从入院前到出院后，PIM 并没有明显增加。这些发现强调需要采取多学科干预措施，以优化老年患者在医院环境中的药物治疗，减少 PIM 对患者的影响。
