中国全科医学2018，Vol.21Issue(5)：566-570,5.DOI:10.3969/j.issn.1007-9572.2017.00.176
基于Beers标准及疾病指南评价老年住院患者抗凝药物潜在性不适当用药
Evaluation of Potentially Inappropriate Use of Anticoagulant Drugs in Elderly Inpatients based on Beers Criteria and Disease Guidelines
摘要
Abstract
Objective This study aimed to evaluate the potentially inappropriate use of anticoagulant drugs in elderly inpatients.Methods Using systematic sampling,we selected 192 elderly inpatients(≥ 65 years) receiving anticoagulant therapy in Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University in 2016. We developed potentially inappropriate medication (PIM) evaluation criteria for anticoagulation therapy in older adults based on the review of the lists and recommended administration methods of non-anti-infective drugs in 2015 American Geriatrics Society Beers Criteria that should be avoided or have their dose adjusted in accordance with the individual's kidney function,drug package inserts, methods of administration proposed in the guidelines for anticoagulation and deep vein thrombosis(DVT) prophylaxis,and the list of anticoagulation drugs for hospitals (enoxaparin injection and rivaroxaban tablets,not including warfarin),and used this criteria to assess the incidence of PIM in these participants.Results Among the 192 patients,the incidence of PIM was 43.8% (84/192). Specifically,the incidence of PIM among the 40 patients using rivaroxaban and 152 using enoxaprin was 20.0% (8/40) and 50.0% (76/152),respectively. The PIM cases included deep venous thrombosis (DVT) prevention (n=30, 35.7%),acute coronary syndrome anticoagulant therapy (n=21,25.0%),DVT prevention after orthopedic surgery (n=10,11.9%),anticoagulation therapy for atrial fibrillation (n=8,9.5%),and other indications for anticoagulation(n=15,17.9%). The inappropriate use of medications mainly included insufficient duration of anticoagulant therapy (n=31, 36.9%),insufficient dose of anticoagulants (n=20,23.8%),avoiding or reducing the dosage due to renal function (n=17, 20.2%),and other inappropriate usage (n=16,19.1%).Conclusion Anticoagulant drug use in elderly inpatients frequently departs from professional recommendations and guidelines,thus comprehensive measures should be taken to prevent the inappropriate use of drugs.关键词
抗凝药/Beers标准/潜在性不适当用药Key words
Anticoagulants/Beers criteria/Potentially inappropriate medication分类
医药卫生引用本文复制引用
范芳芳,胡兰,姜倩,郑丽丽,姚莉..基于Beers标准及疾病指南评价老年住院患者抗凝药物潜在性不适当用药[J].中国全科医学,2018,21(5):566-570,5.基金项目
新疆医科大学科研创新基金(XYDCX201605) （XYDCX201605）
