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1.新疆医科大学药学院,乌鲁木齐 830054
2.新疆医科大学第一附属医院药学部,乌鲁木齐 830011
3.新疆医科大学第七附属医院药学部,乌鲁木齐 830028
4.新疆生产建设兵团医院药学部,乌鲁木齐 830002
5.新疆维吾尔自治区中医医院药学部,乌鲁木齐 830099
药师,硕士研究生。研究方向:临床药学。E-mail:qianhuil1226@163.com
副主任药师,硕士生导师,博士。研究方向:药物经济学、药物流行病和药物利用研究。电话:0991-4361291。E-mail:yubo_wang@xjmu.edu.cn
收稿:2026-02-06,
修回:2026-03-20,
录用:2026-06-08,
纸质出版:2026-06-30
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李乾辉,王建华,杨尚杰,等.乌鲁木齐6家养老机构老年人潜在不适当用药情况及影响因素分析[J].中国药房,2026,37(12):1614-1620.
LI Qianhui,WANG Jianhua,YANG Shangjie,et al.Analysis of potentially inappropriate medication and influencing factors among the elderly in six nursing homes in Urumqi[J].ZHONGGUO YAOFANG,2026,37(12):1614-1620.
李乾辉,王建华,杨尚杰,等.乌鲁木齐6家养老机构老年人潜在不适当用药情况及影响因素分析[J].中国药房,2026,37(12):1614-1620. DOI: 10.6039/j.issn.1001-0408.2026.12.16.
LI Qianhui,WANG Jianhua,YANG Shangjie,et al.Analysis of potentially inappropriate medication and influencing factors among the elderly in six nursing homes in Urumqi[J].ZHONGGUO YAOFANG,2026,37(12):1614-1620. DOI: 10.6039/j.issn.1001-0408.2026.12.16.
目的
2
基于3种潜在不适当用药(PIM)筛查工具调查乌鲁木齐市养老机构老年人PIM的发生情况及影响因素,并比较不同工具的适用性。
方法
2
采用横断面研究设计,于2021年5月至2023年9月选取乌鲁木齐市6家养老机构的老年人作为研究对象。收集老年人的人口学特征、疾病负担及用药记录,分别应用中国PIM标准(2024年版)、美国老年医学会(AGS)Beers标准(2023年版)、老年人潜在不适当处方筛查工具(STOPP)/处方遗漏筛查工具(START)(2023年版)进行PIM筛查。采用Fleiss’s Kappa检验评估3种筛查工具的一致性,采用多因素Logistic回归分析PIM发生的影响因素。
结果
2
中国PIM标准筛查PIM的发生率为47.4%(323/682),AGS Beers标准为43.4%(296/682),STOPP标准为50.9%(347/682)。3种筛查工具的一致性较低(Fleiss’s Kappa=0.12,
P
<0.001)。多因素Logistic回归分析显示,3种筛查工具均提示多重用药、服用阿司匹林、服用精神类药物是养老机构老年人PIM发生的独立危险因素(OR均大于1,
P
<0.05)。
结论
2
乌鲁木齐市养老机构老年人PIM发生率较高;多重用药、服用阿司匹林、服用精神类药物是PIM发生的共同独立危险因素;3种筛查工具的筛查结果存在差异,一致性较低;中国PIM标准可作为养老机构PIM筛查的一线工具。
OBJECTIVE
2
To investigate the prevalence and influencing factors of potentially inappropriate medication (PIM) among the elderly in nursing homes in Urumqi based on three PIM screening tools, and to compare the applicability of different tools.
METHODS
2
A cross-sectional study design was adopted. Elderly individuals from six nursing homes in Urumqi were selected as the research subjects from May 2021 to September 2023. Demographic characteristics, disease burden and medication records of the elderly were collected. PIM screening was performed using the Chinese PIM criteria (2024 edition), the American Geriatrics Society (AGS) Beers criteria (2023 edition), and the Screening Tool of Older Person’S Prescriptions(STOPP)/Screening Tool to Alert to Right Treatment(START) (2023 edition). Fleiss’s Kappa test was used to assess the consistency among the three screening tools, and multivariate Logistic regression was used to analyze the influencing factors of PIM.
RESULTS
2
The prevalence of PIM screened by the Chinese PIM criteria was 47.4% (323/682), by the AGS Beers criteria was 43.4% (296/682), and by the STOPP criteria was 50.9% (347/682). The consistency among the three screening tools was low (Fleiss’s Kappa=0.12,
P
<0.001). Multivariate Logistic regression analysis showed that all three screening tools indicated that polypharmacy, aspirin use and psychotropic drug use were independent risk factors for PIM among elderly in nursing houses (all OR>1,
P
<0.05).
CONCLUSIONS
2
The prevalence of PIM among the elderly in nursing homes in Urumqi is relatively high. Polypharmacy, aspirin use and psychotropic drug use are common independent risk factors for PIM. There are differences in screening results among the three tools with low consistency. The Chinese PIM criteria can serve as a first-line tool for PIM screening in nursing homes.
杜鹏 , 李龙 . 新时代中国人口老龄化长期趋势预测 [J ] . 中国人民大学学报 , 2021 , 35 ( 1 ): 96 - 109 .
PARTRIDGE L , DEELEN J , SLAGBOOM P E . Facing up to the global challenges of ageing [J ] . Nature , 2018 , 561 ( 7721 ): 45 - 56 .
国务院 . 国务院关于印发“十四五”国家老龄事业发展和养老服务体系规划的通知 [EB/OL ] .( 2021-12-30 )[ 2026-05-13 ] . https://www.gov.cn/gongbao/content/2022/content_5678066.htm https://www.gov.cn/gongbao/content/2022/content_5678066.htm .
SU B B , LI D , XIE J Q , et al . Chronic disease in China:geographic and socioeconomic determinants among persons aged 60 and older [J ] . J Am Med Dir Assoc , 2023 , 24 ( 2 ): 206 - 212 .
RANGFAST I , SÖNNERSTAM E , GUSTAFSSON M . Prevalence of potentially inappropriate medications among old people with major neurocognitive disorder in 2012 and 2017 [J ] . BMC Geriatr , 2022 , 22 ( 1 ): 544 .
ZHAO M N , CHEN Z Y , TIAN F Y , et al . Potentially inappropriate medication among people with dementia in China:a nationwide cross-sectional study [J ] . Front Pharmacol , 2022 , 13 : 929584 .
HAGIWARA S , KOMIYAMA J , IWAGAMI M , et al . Polypharmacy and potentially inappropriate medications in older adults who use long-term care services:a cross-sectional study [J ] . BMC Geriatr , 2024 , 24 ( 1 ): 696 .
吴丽梅 . 探索临床药师参与养老院药物治疗的工作模式 [D ] . 广州 : 广州医科大学 , 2020 .
American Geriatrics Society . American Geriatrics Society 2023 updated AGS Beers criteria ® for potentially inappropriate medication use in older adults [J ] . J Am Geriatr Soc , 2023 , 71 ( 7 ): 2052 - 2081 .
XING X X , WANG K , WANG Z Z , et al . Updating the potentially inappropriate medication (PIM):China criteria for 2024:a Delphi consensus study for improved medication safety in older adults [J ] . Int J Clin Pharm , 2026 , 48 ( 1 ): 118 - 126 .
O’MAHONY D , CHERUBINI A , GUITERAS A R , et al . STOPP/START criteria for potentially inappropriate prescribing in older people:version 3 [J ] . Eur Geriatr Med , 2023 , 14 ( 4 ): 625 - 632 .
MORIN L , LAROCHE M L , TEXIER G , et al . Prevalence of potentially inappropriate medication use in older adults living in nursing homes:a systematic review [J ] . J Am Med Dir Assoc , 2016 , 17 ( 9 ): e1 - e9 .
PESEN E , DEMİRCAN C , SIĞIRLI D . Medication errors and potentially inappropriate medication use in elderly patients admitted to the general internal medicine outpatient clinic of a university hospital [J ] . Turk J Intern Med , 2022 , 4 : 63 - 70 .
DRUSCH S , LE TRI T , ANKRI J , et al . Potentially inappro-priate medications in nursing homes and the community older adults using the French health insurance databases [J ] . Pharmacoepidemiol Drug Saf , 2023 , 32 ( 4 ): 475 - 485 .
GARLAND C T , GUÉNETTE L , KRÖGER E , et al . A new care model reduces polypharmacy and potentially inappropriate medications in long-term care [J ] . J Am Med Dir Assoc , 2021 , 22 ( 1 ): 141 - 147 .
COE A B , ZHANG T T , ZULLO A R , et al . Psychotropic medication prescribing in assisted living and nursing home residents with dementia after the national partnership [J ] . J Am Geriatr Soc , 2022 , 70 ( 12 ): 3513 - 3525 .
SHAHID I , NIZAM M A , MOTIANI V , et al . Efficacy and safety of oral P2Y12 inhibitors in older patients with acute coronary syndrome:a frequentist network meta-analysis [J ] . Drugs Aging , 2021 , 38 ( 11 ): 1003 - 1016 .
MA Z , ZHANG C X , CUI X L , et al . Comparison of three criteria for potentially inappropriate medications in Chinese older adults [J ] . Clin Interv Aging , 2018 , 14 : 65 - 72 .
BOLAND B , SIBILLE F X , MOUZON A , et al . Appraisal of the references supporting the STOPP/START version 3 criteria [J/OL ] . Eur Geriatr Med , 2025 : 1 - 6 [ 2026-05-18 ] . https://pubmed.ncbi.nlm.nih.gov/41452533/ https://pubmed.ncbi.nlm.nih.gov/41452533/ . DOI: 10. 1007/s41999-025-01386-7 http://dx.doi.org/10.1007/s41999-025-01386-7 .
SZOSZKIEWICZ M , DESKUR-ŚMIELECKA E , STYSZYŃSKI A , et al . The hidden risks of polypharmacy:exploring potentially inappropriate prescribing with STOPP/START criteria version 3:a cross-sectional study [J ] . PLoS One , 2025 , 20 ( 12 ): e0337586 .
MASNOON N , SHAKIB S , KALISCH-ELLETT L , et al . What is polypharmacy? A systematic review of definitions [J ] . BMC Geriatr , 2017 , 17 ( 1 ): 230 .
KARKI S , THAPA R B , SHRESTHA R . Exploring potentially inappropriate medication use on elderly patients in a general medicine ward using 2023 AGS Beers criteria [J ] . Aging Med , 2025 , 8 ( 3 ): 238 - 248 .
2019 阿司匹林在心血管疾病一级预防中的应用中国专家共识写作组 . 2019阿司匹林在心血管疾病一级预防中的应用中国专家共识 [J/OL ] . 中华心血管病杂志(网络版) , 2019 , 2 ( 1 ): 1 - 5 [ 2026-05-18 ] . https://med.wanfangdata.com.cn/Paper/Detail?id=PeriodicalPaper_zhxxgzzwlb-201901002&dbid=WF_QK.DOI 10.3760/cma.j.issn.2096-1588.2019.10 https://med.wanfangdata.com.cn/Paper/Detail?id=PeriodicalPaper_zhxxgzzwlb-201901002&dbid=WF_QK.DOI10.3760/cma.j.issn.2096-1588.2019.10 .
BLOOMFIELD H E , GREER N , LINSKY A M , et al . Deprescribing for community-dwelling older adults:a systematic review and meta-analysis [J ] . J Gen Intern Med , 2020 , 35 ( 11 ): 3323 - 3332 .
COLE J A , GONÇALVES-BRADLEY D C , ALQAHTANI M , et al . Interventions to improve the appropriate use of polypharmacy for older people [J ] . Cochrane Database Syst Rev , 2023 , 10 ( 10 ): CD008165 .
ZHAO J , CHAE H , AH Y M , et al . Impact of post-admission changes in potentially inappropriate medication use on risk of subsequent hospitalization among nursing home residents [J ] . Front Pharmacol , 2025 , 16 : 1655681 .
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