基于两种标准和药物适宜性指数对老年住院患者多重用药的评估及干预的效果研究

doi:10.5246/jcps.2024.10.070

中国药学(英文版) ›› 2024, Vol. 33 ›› Issue (10): 977-983.DOI: 10.5246/jcps.2024.10.070

• 【研究论文】 • 上一篇

基于两种标准和药物适宜性指数对老年住院患者多重用药的评估及干预的效果研究

王志鹏¹^,^#, 伍致乐²^,^#, 朱健恩¹, 魏理¹^,^*(), 喻鹏久¹^,^*()

^1. 广州医科大学附属第一医院药学部, 广东广州 510120
^2. 广州医科大学附属第一医院老年科, 广东广州 510120

收稿日期:2024-01-21 修回日期:2024-03-03 接受日期:2024-05-10 出版日期:2024-10-31 发布日期:2024-10-31
通讯作者: 魏理, 喻鹏久

Optimizing polypharmacy interventions and evaluating their impact on elderly inpatients using dual criteria and medication appropriateness index

Zhipeng Wang¹^,^#, Zhile Wu²^,^#, Jianen Zhu¹, Li Wei¹^,^*(), Pengjiu Yu¹^,^*()

¹ Department of Pharmacy, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510120, Guandong, China
² Department of Geriatrics, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510120, Guandong, China

Received:2024-01-21 Revised:2024-03-03 Accepted:2024-05-10 Online:2024-10-31 Published:2024-10-31
Contact: Li Wei, Pengjiu Yu
About author:
^# Zhipeng Wang and Zhile Wu contributed equally to this work.
Supported by:
Hospital Pharmacy Research Foundation of Guangdong (Grant No. 2022A14).

摘要/Abstract

摘要：

随着社会老龄化进程的加快, 老年群体多重用药的现象普遍存在。本研究通过对我院老年科2022年1月–2022年9月178名住院患者的潜在不恰当用药情况进行分析, 并将其随机分为观察组和对照组, 其中观察组予以药学干预, 对照组不作干预, 探讨药学干预对老年住院患者多重用药的影响。结果发现药学干预后, 对照组在用药依从性、MAI评分、用药数目和PIM数目方面较干预前无显著性差异(P > 0.05), 观察组较干预前有显著改善(P < 0.05), 用药依从性好的患者比例从57%提高至78%, MAI评分> 10分的患者比例从60%降至40%, 用药数目> 5种的人数从64%降至47%, 至少1个PIM数目的人数从64%降至44%, 明显优于对照组(P < 0.05)。因此, 药学干预能有效改善老年患者用药依从性和适宜性, 减少潜在不恰当用药风险, 促进合理用药。

关键词: 多重用药, 药学干预, 药物适宜性指数, Beers标准

Abstract:

With the acceleration of society’s aging process, the widespread phenomenon of polypharmacy among the elderly has become a significant concern. This research aimed to analyze potential inappropriate medication among 178 inpatients in the geriatric general department of our hospital from January 2022 to September 2022. The participants were randomly assigned to an observation group and a control group. The observation group received pharmaceutical intervention, whereas the control group did not. The objective was to explore the impact of pharmaceutical intervention on polypharmacy in this population. The results revealed that after pharmaceutical intervention, there were no significant differences in medication adherence, medication appropriateness index (MAI), quantity of medicine, and potentially inappropriate medication (PIM) in the control group compared to before the intervention (P > 0.05). However, the observation group showed significant improvement (P < 0.05). The proportion of patients with good adherence increased from 57% to 78%, and the percentage of patients with MAI scores over 10 decreased from 60% to 40%. Moreover, there was a reduction in the number of medications prescribed, with only 47% of patients receiving more than five different types compared to the initial rate of 64%. Additionally, the occurrence of PIM declined from an initial rate of 64% to just 44%, surpassing that observed in the control group. Therefore, the implementation of pharmaceutical intervention can effectively enhance medication adherence and appropriateness among elderly patients, mitigate the risk of PIM, and promote rational medicine utilization.

Key words: Polypharmacy, Pharmaceutical intervention, Medication appropriateness index, Beers Criteria

Supporting:

王志鹏, 伍致乐, 朱健恩, 魏理, 喻鹏久. 基于两种标准和药物适宜性指数对老年住院患者多重用药的评估及干预的效果研究[J]. 中国药学(英文版), 2024, 33(10): 977-983.

Zhipeng Wang, Zhile Wu, Jianen Zhu, Li Wei, Pengjiu Yu. Optimizing polypharmacy interventions and evaluating their impact on elderly inpatients using dual criteria and medication appropriateness index[J]. Journal of Chinese Pharmaceutical Sciences, 2024, 33(10): 977-983.

图/表 4

Table 1. Comparison of the basic conditions between the two patient groups.

Table 2. Two criteria evaluated the top 10 medicines for PIM distribution in elderly inpatients.

Table 3. Comparison of medication adherence and MAI changes in the two groups.

Table 4. Comparison of the quantity of medicine and PIM changes in the two groups.

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基于两种标准和药物适宜性指数对老年住院患者多重用药的评估及干预的效果研究

Optimizing polypharmacy interventions and evaluating their impact on elderly inpatients using dual criteria and medication appropriateness index

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