[关键词]
[摘要]
目的 比较Beers标准(2019版)、老年人不适当处方筛查工具(STOPP)/老年人处方遗漏筛查工具(START)标准(2014版)及中国老年人潜在不适当用药判断标准(中国PIM标准)对河南省人民医院神经内科老年多重用药患者不适当用药的异同。方法 回顾性分析2019年河南省人民医院神经内科住院的老年患者医嘱,以3种标准为评价依据进行对比分析。结果 纳入患者223例,依照中国PIM标准,审查出潜在不适当用药170例,其中高风险40例,低风险126例,疾病状态下潜在不适当用药4例;依照Beers标准,共审查出潜在不适当用药228例,其中避免使用的潜在不适当用药89例,与疾病状态相关的不适当用药10例,谨慎使用药物113例,非抗感染药物间相互作用15例及肾功不全使用非抗感染药物的警示病例1例;依据STOPP/START标准审查出潜在不适当用药109例,处方遗漏70例。结论 各国标准均存在一定的优势和局限性,建议中国标准取长补短,在完善当前内容的同时,增加相互作用、联合用药等内容。
[Key word]
[Abstract]
Objective The Beers criteria (2019 Edition), STOPP/START criteria (2014 Edition) and Chinese elderly potential inappropriate drug use criteria (PIM criteria) were compared for inappropriate drug use among elderly patients in department of Neurology, Henan Provincial People's Hospital.Methods The medical orders of elderly patients hospitalized in the Department of Neurology of Henan Provincial People's Hospital in 2019 were retrospectively analyzed, and the three criteria were used as evaluation basis for comparative analysis.Results A total of 223 patients were included, including 170 cases of potential inappropriate drug use according to Chinese criteria, including 40 cases of high risk, 126 cases of low risk, and 4 cases of potential inappropriate drug use under disease status. A total of 228 cases of potential inappropriate drug use were identified according to Beers criteria, including 89 cases of potential inappropriate drug use avoided, 10 cases of inappropriate drug use related to disease status, 113 cases of cautious drug use, 15 cases of noninfective drug interaction, and 1 case of noninfective drug use warning for renal insufficiency. According to STOPP/START criteria, 109 cases of potential inappropriate drug use and 70 cases of prescription omission were examined.Conclusion There are certain advantages and limitations in the standards of various countries. It is suggested to learn from each other's strengths and complement each other's weaknesses. While improving the current content, the contents of interaction and drug combination should be added.
[中图分类号]
R971
[基金项目]
河南省科技厅科技发展计划项目(202102310656)