34 886例门诊老年患者潜在不适当用药情况及影响因素分析

张欣; 程林; 符佩姝; 戴青; 陈勇川

doi:10.16016/j.1000-5404.202105057

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34 886例门诊老年患者潜在不适当用药情况及影响因素分析

临床医学 | 更新时间：2026-02-13

- 34 886例门诊老年患者潜在不适当用药情况及影响因素分析
- Prevalence and influencing factors of potentially inappropriate medication in elderly outpatients: analysis of 34 886 cases
- 第三军医大学学报 2021年43卷第20期页码：2260-2265
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院药学部
- 作者简介：
  
  [ 陈勇川，E-mail：zwmcyc@163.com CHEN Yongchuan, E-mail: zwmcyc@163.com
- 基金信息：
  
  重庆市科卫联合面上项目(2021MSXM218)
- DOI：10.16016/j.1000-5404.202105057
  中图分类号： R181.35;R339.34;R969.3
- 收稿：2021-05-14，
  
  修回：2021-07-05，
  
  纸质出版：2021-10-30
- 稿件说明：
移动端阅览
张欣, 程林, 符佩姝, 等. 34 886例门诊老年患者潜在不适当用药情况及影响因素分析[J]. 第三军医大学学报, 2021,43(20):2260-2265.

Xin ZHANG, Lin CHENG, Peishu FU, et al. Prevalence and influencing factors of potentially inappropriate medication in elderly outpatients: analysis of 34 886 cases[J]. Journal of Third Military Medical University, 2021, 43(20): 2260-2265.
张欣, 程林, 符佩姝, 等. 34 886例门诊老年患者潜在不适当用药情况及影响因素分析[J]. 第三军医大学学报, 2021,43(20):2260-2265. DOI： 10.16016/j.1000-5404.202105057.

Xin ZHANG, Lin CHENG, Peishu FU, et al. Prevalence and influencing factors of potentially inappropriate medication in elderly outpatients: analysis of 34 886 cases[J]. Journal of Third Military Medical University, 2021, 43(20): 2260-2265. DOI： 10.16016/j.1000-5404.202105057.

摘要

目的

回顾性分析门诊老年患者潜在不适当用药(potentially inappropriate medication，PIM)情况及其影响因素，以提高门诊老年患者合理用药水平。

方法

选取2019年11月1日至2019年12月31日我院门诊部就诊的老年患者(≥65岁)，以Beers标准(2019版) 为依据，分析门诊老年患者PIM发生情况，采用多因素Logistic回归分析PIM的影响因素。

结果

纳入分析的处方案例共34 886例，男性17 162例，女性17 724例，年龄(72.55±6.53)岁，患病种数(2.56±1.65)种，用药品种数(3.34±2.03)种。根据Beers标准(2019版)，PIM的发生率为16.4% (5 721/34 886)，其中5 721例患者存在PIM共6 958项，占比在前3位的药物为复方降压药(19.09%，1 328/6 958)、磺酰脲类降糖药(11.27%，784/6 958)、苯二氮艹卓类药物(10.82%，753/6 958)。PIM主要分布于神经内科、老年病科、内分泌科、心血管内科和中医风湿科。Logistic回归分析显示，年龄≥75岁、用药种数≥5种、疾病种数5~9种以及处方中含复方制剂是门诊老年患者发生PIM的独立危险因素(

0.001)。

结论

门诊老年患者PIM发生率较高，PIM现状仍有待改进，用药品种数多是PIM最重要的危险因素，临床医师及药师应予以重视。

Abstract

Objective

To retrospectively analyze potential inappropriate medication (PIM) and its influencing factors among elderly outpatients in order to improve the rational drug use for them.

Methods

The elderly outpatients (≥65 years old) admitted in our hospital from November 1 to December 30

2019 were enrolled in this study. Their PIMs were evaluated according to the Beers Criteria of the American Geriatric Association 2019. Multivariate logistic regression analysis was used to analyze the influencing factors of PIM.

Results

he prescriptions of 34 886 cases were collected in the analysis. They were 17 162 males and 17 724 females

at an age of 72.55±6.53 years

and had a number of comorbidities of 2.56±1.65 and took 3.34±2.03 kinds of drugs for each patient. According to the 2019 Beers criteria

the incidence of PIM was 16.4% (5 721/34 886)

involving 6 958 times of PIM in 5 721 cases. The top 3 drugs were compound hypotensor (19.09%

1 328/6 958)

sulfonylureas (11.27%

784/6 958) and benzodiazepines (10.82%

753/6 958). The PIM incidence distributed in the departments of neurology

geriatrics

endocrinology

cardiology and traditional medicine and rheumatology. Logistic regression analysis showed that age (≥75 years)

number of medications (≥5)

number of comorbidities (5~9) and prescriptions containing compound preparations were independent risk factors for PIM (

0.001).

Conclusion

According to the 2019 Beers criteria

the incidence of PIM is relatively high in elderly outpatients

so rational drug use needs to be improved in clinical practice. Combination of various drugs is the most important risk factors of PIM

and should be paid attention by clinicians and pharmacists.

关键词

Keywords

references

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