Boateng Irene, Pascual Carlos Rodriguez, Grassby Paul, Asghar Zahid
School of Pharmacy, College of Science, University of Lincoln, Lincoln LN6 7TS, UK.
Community and Health Research Unit, School of Health and Care Sciences, University of Lincoln, Lincoln LN6 7TS, UK.
Explor Res Clin Soc Pharm. 2025 Apr 25;18:100610. doi: 10.1016/j.rcsop.2025.100610. eCollection 2025 Jun.
To determine the association between potentially inappropriate medicines (PIMs) and mortality, hospitalization, adverse drug reactions and falls and specific inappropriate medicines which are associated with the outcomes.
A retrospective cohort study was carried out using 1000 patients aged 75 years and above from the Clinical Practice Research Datalink. PIMs were estimated using the Screening Tool of Older People's Prescriptions. The association between PIMs and mortality, falls, adverse drug reactions, or hospitalization was determined using logistic regression analysis. Subgroup analyses were carried out by including an interaction term between different categories of PIMs and age, gender, and morbidity.
Data of 1000 people were analysed. 36 % were male and the mean age was 83 years. Adjusted odds ratios with their 95 % confidence intervals for association between PIMs and outcomes were: mortality 1.03(0.92 to 1.14), hospitalization 1.21(1.04 to 1.40), falls 1.30(1.12 to 1.51) and adverse drug reactions 1.20(1.02 to 1.40). The effect of PIMs on the outcomes was high in men and ≥ 86 years old and increased with an increasing number of PIMs. Tricyclic antidepressants, elemental iron in doses ≥200 mg daily, benzodiazepines, neuroleptics and long-acting opioids were associated with at least one of the outcomes.
Potentially inappropriate medicines are associated with hospitalization, falls and adverse drug reactions but not mortality.
确定潜在不适当用药（PIMs）与死亡率、住院率、药物不良反应及跌倒之间的关联，以及与这些结果相关的特定不适当药物。
利用临床实践研究数据链对1000名75岁及以上的患者进行了一项回顾性队列研究。使用老年人处方筛查工具评估PIMs。采用逻辑回归分析确定PIMs与死亡率、跌倒、药物不良反应或住院之间的关联。通过纳入不同类别PIMs与年龄、性别和发病率之间的交互项进行亚组分析。
对1000人的数据进行了分析。男性占36%，平均年龄为83岁。PIMs与各结果之间关联的调整比值比及其95%置信区间为：死亡率1.03（0.92至1.14），住院率1.21（1.04至1.40），跌倒1.30（1.12至1.51），药物不良反应1.20（1.02至1.40）。PIMs对男性及86岁及以上人群的结果影响较大，且随着PIMs数量的增加而增加。三环类抗抑郁药、每日剂量≥200mg的元素铁、苯二氮䓬类药物、抗精神病药物和长效阿片类药物与至少一种结果相关。
潜在不适当用药与住院、跌倒和药物不良反应相关，但与死亡率无关。
