老年抑郁症门诊患者中潜在不适当处方的患病率及相关因素：一项中国多中心研究
Prevalence and factors with potentially inappropriate prescribing among older outpatients with depression: a multicentre study across China.
作者信息
Tian Fangyuan, Chen Zhaoyan, Zhang Ying
机构信息
Department of Pharmacy, National Clinical Research Centre for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
出版信息
J Glob Health. 2025 Jul 11;15:04216. doi: 10.7189/jogh.15.04216.
BACKGROUND
Older outpatients with depression are at high risk for potentially inappropriate prescription (PIP). This investigation sought to determine the frequency and associated factors of PIP within Chinese older adults.
METHODS
This cross-sectional study used prescription data from older outpatients with depression from 90 hospitals in seven cities in China from January-December 2021. Risk factor identification for PIP employed multivariate logistic regression analysis. Trend assessment was performed through joinpoint regression to calculate the average annual percent change.
RESULTS
The prevalence of PIP reached 50.42%. The top five PIM were alprazolam, clonazepam, olanzapine, lorazepam, estazolam. The prevalence of PIP decreased from 51.56 to 50.99% (average annual percent change = -0.335%). Logistic regression demonstrated that tertiary-level hospital (odds ratio (OR) = 1.215; 95% confidence interval (CI) = 1.100, 1.342, P < 0.001), department of psychiatry (OR = 1.958; 95% CI = 1.855, 2.067, P < 0.001), age ≥80 (OR = 1.069; 95% CI = 1.016, 1.124, P = 0.01), more diseases (OR = 1.209; 95% CI = 1.092, 1.339, P < 0.001), polypharmacy (OR = 1.672; 95% CI = 1.541, 1.814, P < 0.001) exhibited positive links to PIP among older outpatients suffering from depression.
CONCLUSIONS
This investigation revealed that the occurrence of PIP in older outpatients with depression is high in China.
背景
老年抑郁症门诊患者存在潜在不适当处方（PIP）的高风险。本研究旨在确定中国老年人群中PIP的发生率及其相关因素。
方法
这项横断面研究使用了2021年1月至12月来自中国七个城市90家医院的老年抑郁症门诊患者的处方数据。采用多因素逻辑回归分析确定PIP的危险因素。通过连接点回归进行趋势评估，以计算平均年度变化百分比。
结果
PIP的患病率达到50.42%。前五名的潜在不适当药物为阿普唑仑、氯硝西泮、奥氮平、劳拉西泮、艾司唑仑。PIP的患病率从51.56%降至50.99%（平均年度变化百分比=-0.335%）。逻辑回归表明，在患有抑郁症的老年门诊患者中，三级医院（比值比（OR）=1.215；95%置信区间（CI）=1.100，1.342，P<0.001）、精神科（OR=1.958；95%CI=1.855，2.067，P<0.001）、年龄≥80岁（OR=1.069；95%CI=1.016，1.124，P=0.01）、疾病更多（OR=1.209；95%CI=1.092，1.339，P<0.001）、用药种类多（OR=1.672；95%CI=1.541，1.814，P<0.001）与PIP呈正相关。
结论
本研究表明，中国老年抑郁症门诊患者中PIP的发生率较高。
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