检验医学与临床2024，Vol.21Issue(8)：1079-1086,8.DOI:10.3969/j.issn.1672-9455.2024.08.012
基于Beers标准(2019版)评价河北省多种慢性病共存老年心力衰竭住院患者的潜在不适当用药
Evaluation of potential inappropriate medication in elderly hospitalized patients with multi-chronic disease and heart failure in Hebei Province based on Beers criteria(2019 edition)
摘要
Abstract
Objective To investigate the potentially inappropriate medication(PIM)in elderly hospitalized patients with multi-chronic disease and heart failure in Hebei province based on the Beers criteria(2019 edi-tion)and to analyze the risk factors of PIM in combination with the diagnosis and treatment guidelines of each disease,so as to provide a reference for promoting clinical rational drug use in elderly patients with multi-chro-nic disease and heart failure.Methods The medical record information data of 50 elderly hospitalized patients with heart failure were randomly selected from the information systems of four medical institutions in Hebei Province in January 2022.According to the inclusion and exclusion criteria,135 patients were finally included.PIM in elderly hospitalized patients with heart failure was evaluated based on the Beers criteria(2019 edi-tion),combined with the guidelines for the diagnosis and treatment of diseases,in-depth medication analysis and evaluation were conducted,and medication suggestions were given.Multivariate Logistic regression was used to analyze the influencing factors for PIM in elderly hospitalized patients with heart failure.Results There was no statistically significant difference in the incidence of PIM among elderly hospitalized patients with heart failure with different ages and diseases(P>0.05).There were statistically significant differences in the incidence of PIM among elderly hospitalized patients with heart failure with different genders,types of medication and glomerular filtration rate(GFR)(P<0.05).The top three PIM use were diuretics,spirono-lactone and benzodiazepines.Thirty-eight patients had 53 PIM,and the top three drugs were benzodiazepines,digoxin,and antipsychotic drugs.Twenty-four patients had 26 episodes of PIM,among which patients with chronic kidney disease stage 4 or above used non-steroidal anti-inflammatory drugs,patients with heart failure used non-steroidal anti-inflammatory drugs,and patients with syncope used cholinesterase inhibitors.There were 117 times of high-risk medication in 86 patients,and diuretics were used most frequently in elderly hospi-talized patients.The second was the use of new oral anticoagulants rivaroxaban and dabigatran in patients≥75 years old.There were 22 drug interactions in 21 patients,of which 12 cases occurred in elderly hospitalized pa-tients combined with renin-angiotensin system inhibitors and potassium sparing diuretics.Twenty-two pa-tients with renal insufficiency had 25 PIM,among which the elderly hospitalized patients with creatinine clear-ance rate<30 mL/min used spironolactone most frequently,with a total of 14 PIM.Multivariate Logistic re-gression analysis showed that the fitting degree of regression equation was 83.2%.Female,the types of drugs≥20,and GFR<45 mL/(min·1.73 m2)were the risk factors for PIM in elderly hospitalized patients with heart failure(P<0.05).Conclusion The incidence of PIM in elderly hospitalized patients with multi-chronic diseases and heart failure in Hebei province is high.Female,the types of drugs≥20,and GFR<45 mL/(min·1.73 m2)are risk factors for PIM.The level of rational drug use needs to be improved.关键词
多种慢性病共存/心力衰竭/不合理用药/老年/潜在不适当用药Key words
multi-chronic disease co-existence/heart failure/irrational drug use/old age/poten-tially inappropriate medication分类
医药卫生引用本文复制引用
周晓辉,王淑梅,蔡玥,赵锦,郭珊珊,姚东桂,赵静,吴清华,王娜,张博..基于Beers标准(2019版)评价河北省多种慢性病共存老年心力衰竭住院患者的潜在不适当用药[J].检验医学与临床,2024,21(8):1079-1086,8.基金项目
河北省2020年度医学科学研究课题(20200295). （20200295）
