2021 年第 8 期 第 16 卷

两种标准评价老年住院患者潜在不适当用药情况

Evaluation of potentially inappropriate medication in elderly inpatients based on two criteria

作者：余兰马运芳陈迹

英文作者：Yu Lan Ma Yunfang Chen Ji

单位：新疆医科大学第一附属医院药学部，乌鲁木齐830054

英文单位：Department of Pharmacy the First Affiliated Hospital of Xinjiang Medical University Urumqi 830054 China

关键词：潜在不适当用药；老年人；用药评价；影响因素分析

英文关键词：Potentiallyinappropriatemedications;Elderly;Drugevaluation;Influencingfactorsanalysis

• 摘要：

• 目的 采用2种潜在不适当用药(PIM)标准（2019版Beers标准和2017版中国标准）分析医院老年住院患者PIM情况。方法 采取随机抽样的方法从新疆医科大学第一附属医院老年病科2019年1—8月出院患者中随机抽取符合纳入标准的老年住院患者400例。分别以2019版Beers标准和2017版中国标准为依据，对老年住院患者PIM情况及其危险因素进行分析。结果 400例老年住院患者年龄（76±7）岁，患病(10±5)种，用药（11±6)种。400例老年患者中，中国标准筛选出PIM病例159例(39.8%)，Beers标准筛选出PIM病例178例(44.5%)。老年患者PIM频次排序前3的药物，中国标准为氯吡格雷、阿普唑仑、多索茶碱，Beers标准为埃索美拉唑、阿普唑仑、螺内酯。多因素Logistic回归分析显示，男性、年龄≥81岁、合并疾病≥5种与用药≥10种是老年人PIM的独立危险因素(均P＜0.05)。结论 2019版Beers标准在给药建议上较2017版中国标准更为严格。药物治疗过程中对于年龄≥81岁、合并疾病≥5种、用药≥10种的老年人，应重点关注PIM可能导致的药物不良事件。

• Objective To analyze potentially inappropriate medication (PIM) situation of elderly inpatients by two PIM criteria ［Beers criterion (Version 2019) and Chinese criterion (Version 2017)］. Methods From January to August 2019, 400 elderly inpatients meeting the inclusion criteria and discharging from Department of Geriatrics, the First Affiliated Hospital of Xinjiang Medical University were randomly selected. Beers criterion (version 2019) and Chinese criterion (version 2017) were used as the references to analyze PIM and its risk factors of elderly inpatients. Results The age of 400 elderly inpatients was （76±7）years old, the kinds of diseases was (10±5) and the kinds of medication was (11±6). Among 400 elderly inpatients, there were 159 cases(39.8%) of elderly PIM screened by Chinese criterion and 178 cases(44.5%) of elderly PIM screened by Beers criterion. The top three drugs of PIM frequency in elderly patients were screened, which were clopidogrel, alprazolam and doxofylline by Chinese criterion and esomeprazole, alprazolam and spironolactone by Beers criterion, respectively. Multivariate Logistic regression analysis showed that male, aged≥81 years old, comorbid diseases≥5, medication kinds≥10 were independent risk factors for elderly PIM (all P＜0.05). Conclusion s The medication recommendations of the Beers criterion (version 2019) are more stringent than the Chinese criterion(version 2017). During drug treatments, attention should be paid to adverse drug events probably caused by PIM for the elderly with aged≥81 years old, comorbid diseases≥5, and medication kinds≥10.