摘要
背景使用精神类药物,尤其是镇静催眠药,可增加老年人的跌倒风险。目的了解社区规范化管理老年慢性病患者的镇静催眠药使用情况。方法于2018年1—3月,采用系统抽样法,在北京市西城区月坛社区已接受规范化管理的老年(60～80岁)慢性病患者中选取581例进行调查,其中高血压、糖尿病、脑卒中、冠心病患者分别为512、277、50、190例。通过查阅2017年电子病历系统,收集患者的镇静催眠药使用情况。结果 193例(33.2%)老年慢性病患者确诊为失眠症且使用了镇静催眠药。随着年龄、患慢性病种数的增加,患者的镇静催眠药使用率升高(P<0.05);患2种慢性病者的镇静催眠药使用率高于患1种慢性病者(P<0.05)。使用率排在前3位的镇静催眠药为艾司唑仑(63.2%,122/193)、唑吡坦(18.7%,36/193)、佐匹克隆(15.5%,30/193)。95.9%(185/193)的患者采用常规剂量,4.1%(8/193)的患者采用加大剂量。31.6%(61/193)的患者有6个月以上需要间断使用镇静催眠药,68.4%(132/193)患者的服药时间为1～2个月。结论老年慢性病患者的镇静催眠药使用率较高,且随着年龄和慢性病患病种数的增加而增加,但长期用药率不高。应关注高龄患者及合并多种慢性病患者的用药情况并给予其健康指导,以减少跌倒等不良健康事件的发生。
Background Inappropriate use of psychotropic drugs,especially sedatives and hypnotics,can increase the risk of falls in older people.Objective To examine the use of sedative and hypnotic drugs in elderly chronic disease patients receiving standardized community-based management.Methods By use of systematic sampling,we selected 581 cases as the participants from 60-80-year-old chronic disease patients receiving standardized community-based management from January to March in 2018 from Yuetan Community,Xicheng District,Beijing,including 512 of hypertension,277 of diabetes,50 of stroke and 190 of coronary heart disease.By consulting the electronic medical record system in 2017,we collected the data concerning sedative and hypnotic drugs use in the participants.Results Of the participants,33.2%(193 cases)with a definite diagnosis of insomnia used sedative and hypnotic drugs.And the use rate of such drugs increased with age and number of chronic diseases(P<0.05).Participants with 2 chronic diseases had higher use rate of sedative and hypnotic drugs than those with only 1(P<0.05).The most frequently used three drugs were estazolam(63.2%,122/193),zolpidem(18.7%,36/193),and zopiclone(15.5%,30/193).Most of the participants〔95.9%(185/193)〕used a normal dose,only 4.1%(8/193)used an increased dose.31.6%(61/193)needed to use such drugs intermittently for at least 6 months each year,and 68.4%(132/193)used for 1-2 months.Conclusion The use rate of sedative and hypnotic drugs in elderly chronic disease patients is high,and it increases with age and the number of chronic diseases,but the long-term use rate is not high.In view of this,we should pay attention to the medication status of those at a very advanced age or with multiple chronic diseases,and give them medication guidance,to reduce the occurrence of falls and other adverse health events。
作者
杨瑛
孙艳格
闫岩
李超
吕凯敏
YANG Ying;SUN Yange*;YAN Yan;LI Chao;LYU Kaimin(Yuetan Community Health Center,Fuxing Hospital,Capital Medical University,Beijing 100045,China)
出处
《中国全科医学》
CAS
北大核心
2019年第13期1613-1617,共5页
Chinese General Practice
基金
2017年度首都全科医学研究专项课题(17QK21)
北京市卫生系统高层次卫生技术人才培养计划(2014-3-103)
关键词
健康管理
老年人
慢性病
入睡和睡眠障碍
催眠药和镇静药
Health management
Aged
Chronic disease
Sleep initiation and maintenance disorders
Hypnotics and sedatives
