根据 2023 年 Beers 标准，住院老年患者中潜在不当用药的发生率、决定因素和健康结果

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics Pub Date : 2024-11-13 DOI:10.1016/j.archger.2024.105693

Kittipak Jenghua , Sirayut Phatthanasobhon , Duangkamon Poolpun

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引用次数: 0

摘要

背景本研究旨在确定住院老年患者中潜在不当用药（PIM）的发生率、决定因素和再住院结果。设计和参与者本回顾性队列研究分析了 2021 年至 2023 年期间一家三级医院收治的老年患者。我们采用 2023 年的 Beers 标准对 PIM 处方进行了评估，并将患者分为 PIM 使用者和非使用者。我们评估了 PIM 的使用率，确定了其决定因素，并调查了 PIM 的使用与出院后一年内因任何原因再次住院之间的关系，以及相关的住院时间和医疗总费用。结果这项研究包括 20629 名住院的老年患者，平均年龄为 71.17 ± 8.14 岁，其中 50.21% 为女性。91.32%的患者普遍使用 PIM。使用 PIM 的决定因素包括女性、住院时间较长、处方药数量增加以及患有三种或三种以上慢性疾病。然而，使用 PIM 并不会显著增加再次住院的风险（调整后危险比 = 1.02；95% CI = 0.87-1.19）、住院时间（调整后平均差 [aMD] = 0.35 天；95% CI = -1.31 至 2.结论住院老年患者使用 PIMs 的比例仍然高得惊人，并且与处方药的数量密切相关。然而，在一年内，PIM 的使用与再住院结果之间并没有发现明显的联系。

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Prevalence, determinants, and health outcomes of potentially inappropriate medication use according to the 2023 beers criteria among hospitalised older patients

Background

This study aims to determine the prevalence, determinants, and rehospitalisation outcomes of potentially inappropriate medication (PIM) use among hospitalised older patients.

Design and participants

This retrospective cohort study analysed older patients admitted to a tertiary care hospital from 2021 to 2023. We evaluated PIM prescriptions using the 2023 Beers criteria, classifying the patients as PIM users or non-users. We assessed the prevalence of PIM use, identified its determinants, and investigated the association between PIM use and rehospitalisation for any reason within one year of discharge, as well as the related length of stay and total medical costs.

Results

The study comprised 20,629 hospitalised older patients with a mean age of 71.17 ± 8.14 years, 50.21% of whom were women. PIM usage was prevalent among 91.32% of the patients. The determinants of PIM use included being female, having a longer hospital stay, an increasing number of prescribed drugs, and three or more chronic conditions. However, the use of PIM did not significantly increase the risk of rehospitalisation (adjusted hazard ratios = 1.02; 95% CI = 0.87–1.19), length of stay (adjusted mean difference [aMD] = 0.35 days; 95% CI = -1.31 to 2.01 days), or cost of medical care (aMD = 2,039 Baht; 95% CI = -9,824 to 13,901 Baht).

Conclusions

The use of PIMs among hospitalised older patients remains alarmingly high and is strongly correlated with the number of prescribed drugs. However, no significant link was found between PIM use and rehospitalisation outcomes within a one-year period.

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来源期刊

Archives of gerontology and geriatrics 医学-老年医学

CiteScore

7.30

自引率

5.00%

发文量

198

审稿时长

16 days

期刊介绍： Archives of Gerontology and Geriatrics provides a medium for the publication of papers from the fields of experimental gerontology and clinical and social geriatrics. The principal aim of the journal is to facilitate the exchange of information between specialists in these three fields of gerontological research. Experimental papers dealing with the basic mechanisms of aging at molecular, cellular, tissue or organ levels will be published. Clinical papers will be accepted if they provide sufficiently new information or are of fundamental importance for the knowledge of human aging. Purely descriptive clinical papers will be accepted only if the results permit further interpretation. Papers dealing with anti-aging pharmacological preparations in humans are welcome. Papers on the social aspects of geriatrics will be accepted if they are of general interest regarding the epidemiology of aging and the efficiency and working methods of the social organizations for the health care of the elderly.