| 刘文凯,朱虚阳,王伟娇,等.门诊老年共病患者多重用药安全性的调查研究[J].中国临床保健杂志,2025,28(1):98-102. |
| 门诊老年共病患者多重用药安全性的调查研究 |
| Investigation on the safety of multidrug use in outpatient with senile comorbidities |
| 投稿时间：2024-10-17 |
| DOI：10.3969/J.issn.1672-6790.2025.01.018 |
| 中文关键词: 共病现象 多种药物疗法 处方不当 门诊病人 老年人 |
| 英文关键词: Comorbidity Polypharmacy Inappropriate prescribing Outpatients Aged 〖FL |
| 基金项目:安徽省医疗卫生重点专科建设项目(皖卫函〔2021〕273号) |
| 作者 | 单位 | E-mail | | 刘文凯 | 安徽医科大学药学院,合肥 230032
安徽医科大学第三附属医院药学部,合肥 230061 | qinkan99@163.com | | 朱虚阳 | 安徽医科大学药学院,合肥 230032
安徽医科大学第三附属医院药学部,合肥 230061 | qinkan99@163.com | | 王伟娇 | 安徽医科大学药学院,合肥 230032
安徽医科大学第三附属医院药学部,合肥 230061 | qinkan99@163.com | | 彭义维 | 安徽医科大学药学院,合肥 230032
安徽医科大学第三附属医院药学部,合肥 230061 | qinkan99@163.com | | 田念 | 安徽医科大学药学院,合肥 230032
安徽医科大学第三附属医院药学部,合肥 230061 | qinkan99@163.com | | 秦侃 | 安徽医科大学药学院,合肥 230032
安徽医科大学第三附属医院药学部,合肥 230061 | qinkan99@163.com |
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| 中文摘要: |
| 目的 调查老年共病患者多重用药的现状,探讨不适当用药引发安全性问题的影响因素。方法 回顾性分析2023年1月至2024年6月在安徽医科大学第三附属医院门诊的526例老年共病多重用药患者电子病历。对患者使用药品进行分类统计；使用年龄校正Charlson合并症指数(aCCI)量化患者死亡风险；Beers标准(2023版)评估患者潜在不适当用药(PIM)风险；抗胆碱能认知负担量表(ACB)评估患者抗胆碱能风险；采用二元logistic回归分析影响患者潜在不适当用药的影响因素。结果 526例患者患病种类为(4.14±1.37)种,使用的药品种类数为(12.48±5.88)种；发生PIM风险422例,占比总入组病例数的80.23%；PIM发生风险主要分布在苯二氮类镇静催眠药(124例)及抗血栓药(107例)。二元logistic回归结果显示,性别、患病种类数、使用药品种类数是PIM发生的影响因素(P＜0.05)。ACB评分显示,入组患者中大部分存在抗胆碱能认知风险(320例,60.84％)。aCCI评分显示,入组患者共病情况严重(≥7分,210例),10年生存率较低。结论 老年共病多重用药人群PIM发生率高,抗胆碱能认知负担风险较高。性别、患病种类数、使用药品种类数是PIM发生的影响因素。 |
| 英文摘要: |
| Objective To investigate the current situation of multiple drug use in elderly patients with comorbidities and identify potential factors that may affect safety issues caused by inappropriate drug use in such patients.Method A retrospective analysis was conducted on the electronic medical records of 526 elderly patients with comorbidities and multiple drug use who visited the outpatient department of the Third Affiliated Hospital of Anhui Medical University from January 2023 to June 2024.Classify and statistically analyze the use of drugs in enrolled patients based on the criteria of anatomical therapy and chemical classification (ATC).Quantify patient mortality risk using age corrected Charlson comorbidity index (aCCI).The Beers criteria (2023 edition) was used to assess the potential risk of inappropriate drug use (PIM) in patients.Assessment of anticholinergic risk in patients using the anticholinergic cognitive burden scale (ACB).Use binary logistic regression analysis to identify the influencing factors of potential inappropriate medication use in patients.Results The types of diseases in 526 patients were 4.14±1.37,and the number of drugs used was 12.48±5.88;422 cases of PIM risk occurred,accounting for 80.23% of the total enrolled cases;the risk of PIM mainly distributed among benzodiazepine sedatives and hypnotics (124 cases) and antithrombotic drugs (107 cases).The binary logistic regression results showed that gender,number of types of diseases,and number of types of drugs used were the influencing factors of PIM occurrence (P<0.05).The ACB score results showed that the majority of enrolled patients had a risk of anticholinergic cognition (320 cases,60.84%).The aCCI score results showed that the comorbidities of the enrolled patients were severe (≥ 7 points,210 cases),and the ten-year survival rate was relatively low.Conclusions The incidence of PIM is high in the elderly population with comorbidities and multiple drug use,and the risk of anticholinergic cognitive burden is high.Gender,number of types of diseases,and number of types of drugs used are influencing factors for the occurrence of PIM. |
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