【作者】 倪冰玉； 傅孟元； 谢克扎提·乌苏曼江； 史录文； 管晓东；

【机构】 北京大学药学院药事管理与临床药学系； 北京大学医药管理国际研究中心；

【摘要】 目的:评价东城区社区医疗机构老年人潜在不适当用药(Potentially Inappropriate Medication,PIM)情况并探究其影响因素。方法:提取东城区社区医疗机构2017年60岁及以上老年患者门诊处方数据,依据《中国老年人潜在不适当用药判断标准(2017年版)》分析PIM基本情况和药物分布,采用Logistic模型分析PIM影响因素。结果:研究最终纳入1045269张处方,PIM发生率为12.9%;排名前三位的PIM药物为氯吡格雷(42.5%)、艾司唑仑(24.2%)和布洛芬(11.4%);Logistic回归结果显示,社区卫生服务中心、男性、初级职称医师,患病数、药品数较多、男性、高龄患者的PIM风险更高。结论:东城区社区医疗机构老年人PIM情况有待改善,推广老年人PIM判断标准,加强对于老年患者用药的风险评估具有重要意义。更多还原

【Abstract】 Objective: To evaluate the prevalence and risk factors of potentially inappropriate medication(PIM) among elderly inpatients in community health care institutions in Dongcheng District. Methods: The outpatient prescriptions of patients aged 60 and above in community health care institutions in Dongcheng district in 2017 were analyzed. The proportion of PIM prescriptions and the utilization rate of PIM drugs were calculated according to the criteria of potentially inappropriate medications for older adults in China(2017). Logistic model was built to analysis the influence factors of PIM. Results: 1045269 prescriptions were collected in this study. 12.9% prescriptions had at least one PIM prescribed. The top 3 drugs in PIM prescriptions were clopidogrel(42.5%), estazolam(24.2%) and ibuprofen(11.4%). The logistic regression analysis revealed that the significant predictors for PIM prescription were: visits of healthcare center; doctors’ male gender and lower-class title; patients’ male gender, elder age, more illness and more drugs. Conclusion: The situation of PIM prescriptions needs to be improved for the elderly inpatients in community health care institutions in Dongcheng District. To reduce the incidence of PIM in elderly patients, the criteria of potentially inappropriate medications for older adults in China requires further promotion.更多还原