湖北省社区老年患者潜在不适当用药现状研究OA

Background As China's population ages,there is a growing concern about the prevalence of polypharmacy among the elderly and the phenomenon of potential irrational drug use among this demographic.Objective To investigate the potential inappropriate medication(PIM)and potential prescription omission in the community elderly patients by three different evaluation criteria,and to provide evidence for regulating the management of drug therapy for the elderly.Methods From April 2021 to June 2021,this study adopted the method of cluster sampling to select Wuhan,Yichang,Qianjiang and Zhijiang in Hubei Province as sample areas.A total of 12 communities in 3 streets or towns were randomly selected from each as research units.Elderly patients in the communities who met the pre-established inclusion and exclusion criteria were selected as the research subjects.Comprehensively applying the Beers criteria(2023 edition),the Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment(STOPP/START)criteria(2014 edition),and the Chinese Criteria for Potentially Inappropriate Medication Use in Elderly People(2017 edition),the PIM and potential prescription omissions of elderly patients in the communities of Hubei Province were analyzed.Results A total of 1 011 elderly patients in the community were included,among whom 420 were male patients(43.08%)and 591 were female patients(57.92%).The comparison of the number of medication types among patients of different genders,ages and types of chronic diseases showed statistically significant differences(P<0.05).PIM was detected in 294 cases(29.08%)of patients using the Beers criteria(2023 edition).Using the STOPP/START criteria(2014 edition),PIM was detected in 189 patients(18.69%),and a total of 229 cases of prescription omission occurred.According to the Chinese criteria for PIM use in elderly people(2017 edition),PIM was detected in 296 cases(29.28%)of patients.The drug with the highest frequency of PIM detected by Beers criteria(2023 edition)was fast-release nifedipine.The drug with the highest frequency of PIM was non-steroidal anti-inflammatory drugs according to STOPP/START criteria(2014 edition),and the item with the highest frequency of prescription omission was type 2 diabetes without metformin treatment.The drug with the highest PIM frequency detected by Chinese criteria for PIM use in elderly people(2017 edition)was nifedipine.Conclusion The problems of PIM and prescription omission in the course of treatment of community elderly patients should be paid attention to,and it is necessary to strengthen the drug therapy management of community elderly patients.The three criteria each other to a certain extent,enabling a more comprehensive screening of PIM and prescription omission issues.