摘要
目的保障高血压并脑梗死老年患者的用药安全。方法使用医院信息系统提取医院2020年高血压并脑梗死老年(≥65岁)患者的用药医嘱,采用老年患者潜在不适当用药(PIM)Beers标准(2019版)分析患者PIM发生情况,通过多因素Logistic回归法分析患者(PIM)发生的独立危险因素。结果纳入患者115例,发生PIM 109例(94.78%)、334例次。PIM分类以使用老年患者应慎用药物的发生例次最高(180例次,53.89%),其次为与药物相关(121例次,36.23%);发生PIM频次较高的药品主要有阿司匹林肠溶片(78例,23.35%)、呋塞米(31例,9.28%)、螺内酯片(29例,8.68%)等;21例次PIM与疾病或症状有关,其中95.23%有肾功能不全病史;12例次PIM涉及药物相互作用,主要包括非甾体抗炎药与皮质类固醇联用,2种肾素-血管紧张素系统(RAS)抑制剂联用,以及1种RAS抑制剂与保钾利尿剂联用。多因素Logistic回归分析显示,仅用药种类>9种是患者PIM发生的独立危险因素[OR=10.056,95%CI(3.053,33.117),P<0.001]。结论高血压并脑梗死患者PIM较多,建议药师开展临床药学工作时,将Beers标准与临床实际相结合以判断用药安全风险。
Objective To ensure the medication safety of elderly patients with hypertension and cerebral infarction.Methods The medication orders of elderly patients(≥65 years)with hypertension and cerebral infarction were extracted by the hospital information system in 2020.The occurence of potentially inappropriate medication(PIM)in patients was analyzed by the American Geriatrics Society 2019 Updated AGS Beers Criteria®for Potentially Inappropriate Medication Use in Older Adults(hereinafter referred to as the Beers Criteria),and the independent risk factors for PIM were analyzed by the multivariate Logistic regression analysis.Results A total of 115 patients were included,of which 109 patients(94.78%)had PIM,involving 334 cases.The incidence of PIM related to careless medication in elderly patients was the highest(180 cases,53.89%),followed by drug-related PIM(121 cases,36.23%).Aspirin Enteric-Coated Tablets(78 cases,23.35%),Furosemide(31 cases,9.28%),Spironolactone Tablets(29 cases,8.68%)were related to a high frequency of PIM.Twenty-one cases of PIM were related to disease or symptoms,of which 95.23%cases had a history of renal insufficiency.Twelve cases of PIM involved drug interactions,mainly including the combination of nonsteroidal anti-inflammatory drugs and corticosteroids,the combination of two renin-angiotensin system(RAS)inhibitors,the combination of one RAS inhibitor and potassium sparing diuretics.Multivariate Logistic regression analysis showed that only medication>nine varieties was the independent risk factor for PIM in patients[OR=10.056,95%CI(3.053,33.117),P<0.001].Conclusion The incidence of PIM in elderly patients with hypertension and cerebral infarction is high,and it is suggested that pharmacists should determine medication safety risks based on the Beers Criteria and clinical practice.
作者
宦娣
叶根深
李佳会
刘忠明
HUAN Di;YE Genshen;LI Jiahui;LIU Zhongming(The First People's Hospital of Bengbu,Bengbu,Anhui,China 233000)
出处
《中国药业》
CAS
2024年第2期128-128,I0001-I0004,共5页
China Pharmaceuticals
基金
安徽省蚌埠市科技创新指导类项目[20210304]。
关键词
Beers标准
高血压
脑梗死
老年患者
潜在不适当用药
药学服务
Beers Criteria
hypertension
cerebral infarction
elderly patient
potentially inappropriate medication
pharmaceutical care
