摘要
目的探寻老年2型糖尿病患者潜在不适当用药(potentially inappropriate medication,PIM)发生情况及影响因素,为提高安全用药提供依据。方法依据《中国老年人潜在不适当用药判断标准》(2017版)统计于2018年1月至2020年12月在秦皇岛市第一医院老年病科住院的≥65岁的糖尿病患者潜在不适当用药情况,通过Spearman分析其相关性,卡方(χ^(2))检验和二分类Logistic回归分析其相关影响因素。结果纳入312例老年住院糖尿病患者,平均年龄(78.59±7.79)岁,其中男性150例,女性162例;平均共病数量为(5.10±1.64)种;联合用药数量(6.50±2.75)种;76.30%的患者为多重用药;其中共有180例患者发生270例次PIM情况,与药物相关的PIM存在259例,与疾病状态相关的PIM有11例;最常见的PIM是使用胰岛素及氯吡格雷;老年糖尿病患者PIM的发生与年龄、慢病共病数量、CCI评分、联合用药数量以及冠心病、充血性心力衰竭、心肌梗死等慢性病具有相关性;联合用药数量和慢病共病数量为PIM发生的独立影响因素。结论住院老年糖尿病患者PIM发生率仍然较高,临床医师应对老年人合理用药提起足够的重视,尤其是胰岛素的应用,应高度警惕其用药情况。
Objective To explore the occurrence and influencing factors of potential inappropriate drug use in elderly diabetes mellitus type 2 patients and to explore its correlation and influencing factors with chronic disease comorbidities,so as to provide reference for clinical rational medication use.Methods According to the Criteria of potentially inappropriate medications for older adults in China(2017 edition),the potential inappropriate drug use among diabetes patients≥65 years old hospitalized in the department of geriatrics the First Hospital of Qinhuangdao City during January 2018 to December 2020 was analyzed by Spearman's-correlation,and binary Logistic regression was used to analyze the related risk factors.Results The average age of the 312 elderly patients with diabetes mellitus type 2 was(78.59±7.79)years,including 150 males and 162 females;the average number of patients with multiple chronic diseases was(5.10±1.64);the average type of medication was(6.50±2.75);the patients with polypharmacy accounted for 76.30%.There were 270 cases of PIM in 180 patients,259 cases of drug-related PIM and 11 cases of PIM related to disease status.The most common PIM is insulin and clopidogrel.The occurrence of PIM in elderly diabetic patients was correlated with age,number of chronic disease comorbidities,CCI score,number of drug combination,coronary heart disease,congestive heart failure,myocardial infarction and other chronic diseases.The number of drug combinations and chronic comorbidities were the influencing factors of the occurrence of PIM.Conclusion The incidence of PIM in hospitalized elderly patients with diabetes is still high.Clinicians should pay enough attention to rational drug use in the elderly,especially the use of insulin,and should be highly alert to their drug use.
作者
白喜同
张鹏宇
BAI Xitong;ZHANG Pengyu(Chengde Medical University,Chengde 067000,China;Department of Geriatrics,the First Hospital of Qinhuangdao,Qinghuangdao 066000,China)
出处
《中国医药指南》
2023年第7期1-6,共6页
Guide of China Medicine
关键词
潜在不适当用药
老年人
糖尿病
Potentially inappropriate medication
Elderly
Diabetes mellitus
