| 曾平,朱鸣雷,闫雪莲,等.老年住院患者多重用药与老年综合征的关系[J].中国临床保健杂志,2019,22(3):322-326. |
| 老年住院患者多重用药与老年综合征的关系 |
| The relationship of polypharmacy and geriatric syndrome among elder inpatients |
| 投稿时间：2019-02-20 |
| DOI：10.3969/J.issn.1672-6790.2019.03.009 |
| 中文关键词: 多种药物疗法 老年综合征 慢性病共病 综合评估 老年人 |
| 英文关键词: Polypharmacy Geriatrics syndrome Multiple chronic conditions Comprehensive evaluation Aged 〖FL |
| 基金项目:北京市科学技术委员会资助项目(Z171100001017251) |
| 作者 | 单位 | E-mail | | 曾平 | 中国医学科学院 北京协和医学院 北京协和医院, 老年医学科,药剂科,北京 100730 | magsie@126.com | | 朱鸣雷 | 中国医学科学院 北京协和医学院 北京协和医院, 老年医学科,药剂科,北京 100730 | | | 闫雪莲 | 中国医学科学院 北京协和医学院 北京协和医院 药剂科,北京 100730 | | | 刘晓红 | 中国医学科学院 北京协和医学院 北京协和医院, 老年医学科,药剂科,北京 100730 | xhliu41@medmail.com.cn |
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| 中文摘要: |
| 目的 研究老年住院患者多重用药与老年综合征的关系。方法 应用老年综合评估方法调查老年住院患者用药清单及合并老年综合征情况。结果 选取60岁以上老年住院患者281例,年龄(73.6±7.6)岁,平均共病5种,平均用药4种,多重用药占48.0%。最常使用药物种类依次与下列慢性病有关:心脑血管疾病、消化系统、神经系统。最常使用药物依次为:阿司匹林92例 32.7%),阿托伐他汀65例(23.1%),美托洛尔53例(18.9%)。用药种类与共病数量呈显著正相关(r=0.62,P<0.01),多重共病患者多重用药风险显著增加(χ2=32.0,P<0.01)。多重用药也与日常生活活动受损(χ2=7.4,P<0.01)、衰弱(χ2=6.4,P=0.02)、疼痛(χ2=4.7,P=0.03)、便秘(χ2=5.8,P=0.02)显著相关。结论 老年科住院患者多重用药发生率高,同时伴随多种慢性情况,需要医师与药师合作,综合评估,并根据评估结果进行个体化全人管理和药物重整。 |
| 英文摘要: |
| Objective To study the relationship of polypharmacy and geriatric syndrome among elder inpatients.Methods Determine geriatric syndrome and drug list after the evaluation of the patients with comprehensive geriatric assessment.Results A total of 281 inpatients aged over 60 years old accepted CGA during their hospitalization.The participants were at an age of (73.6±7.6) years with 5.9±4.1 comorbidities,as well as an average number of 4.9±3.7 for medicine use.48% had polypharmacy.The most commonly used prescription are drugs for cardio-cerebrovascular disease,digestive system diseases,neurological diseases,and the most common used drugs were aspirin 92(32.7 %),atorvastatin 65(23.1 %) and metoprolol 53(18.9 %).Linear regression analysis revealed significant and independent association of number of drug use with number of comorbidities (P<0.001,B=0.62).Patients with multimobidity(χ2=32,P<0.01),dependence at ADL-IADL(χ2=7.4,P<0.01),frailty(χ2=6.4,P=0.02),pain(χ2=4.7,P=0.03),or constipation (χ2=5.8,P=0.02) had significantly higher rate of polypharmacy.Conclusions Elder inpatients had more multiple chronic conditions as well as more drugs use,it is nessesary for geriatric physicians to conduct CGA with the help of pharmacists among elder patients,and perform holistic management including medication reconciliation individually. |
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