持续改进老年住院患者中枢神经系统疾病相关药物的合理使用

IF 2.1 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of Clinical Pharmacy and Therapeutics Pub Date : 2023-05-13 DOI:10.1155/2023/1634743

Fang Li, Yingli Zhu, Min Li, Yinpeng Xu, Yahui Cui, Ying Yang, Yaling Wang, H. Hao

{"title":"持续改进老年住院患者中枢神经系统疾病相关药物的合理使用","authors":"Fang Li, Yingli Zhu, Min Li, Yinpeng Xu, Yahui Cui, Ying Yang, Yaling Wang, H. Hao","doi":"10.1155/2023/1634743","DOIUrl":null,"url":null,"abstract":"What Is Known? In elderly inpatients, potential inappropriate medication (PIM) is a prominent prescription challenge. However, there is limited information available regarding PIM in patients with central nervous system (CNS) diseases in China. Objective. To evaluate and improve the rational use of drugs for the treatment of CNS diseases in elderly inpatients. Method. A retrospective, cross-sectional study was conducted among elderly inpatients (≥65 years) admitted to the Ninth People’s Hospital of Zhengzhou in China from March 2020 to March 2021. PIM was identified based on the 2019 Beers criteria at admission and discharge. The patients recruited in March 2020 were considered a baseline group, which was used as a comparison to evaluate PIM of CNS disease-related drugs in June 2020, September 2020, December 2020, and March 2021. Results. A total of 1500 patients were included in the evaluation. There was a statistically significant difference in the number of average hospitalization days, drug varieties used, and PIM detection (\n \n p\n <\n 0.05\n \n ), as determined by X2 test. A total of 332 cases of PIM were identified, and 226 cases were detected for the interaction with CNS disease dementia. Multifactor logistic regression analysis showed that male, length of stay ≥15 days, and >10 medication types were risk factors for the occurrence of PIM (\n \n p\n <\n 0.05\n \n ). After clinical supervision and training based on the High-Risk Drug Replacement Program for the Elderly, the rate of irrational medication under medical advice decreased from 34.67% in March 2020 to 14.0% (\n \n p\n <\n 0.001\n \n ) in March 2021. What Is New and Conclusion. There was certain rationality based on the High-Risk Drug Replacement Program for the Elderly, and the rates of selective serotonin reuptake inhibitor, 5-hydroxylamine/norepinephrine re-intake inhibitor, rotenone, quetiapine, and proton pump inhibitor use were improved. These results provide a reference for the continuous improvement of the PIM catalog for elderly patients.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2023-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Continuous Improvement of the Rational Use of Central Nervous System Disease-Related Drugs in Elderly Inpatients\",\"authors\":\"Fang Li, Yingli Zhu, Min Li, Yinpeng Xu, Yahui Cui, Ying Yang, Yaling Wang, H. Hao\",\"doi\":\"10.1155/2023/1634743\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"What Is Known? In elderly inpatients, potential inappropriate medication (PIM) is a prominent prescription challenge. However, there is limited information available regarding PIM in patients with central nervous system (CNS) diseases in China. Objective. To evaluate and improve the rational use of drugs for the treatment of CNS diseases in elderly inpatients. Method. A retrospective, cross-sectional study was conducted among elderly inpatients (≥65 years) admitted to the Ninth People’s Hospital of Zhengzhou in China from March 2020 to March 2021. PIM was identified based on the 2019 Beers criteria at admission and discharge. The patients recruited in March 2020 were considered a baseline group, which was used as a comparison to evaluate PIM of CNS disease-related drugs in June 2020, September 2020, December 2020, and March 2021. Results. A total of 1500 patients were included in the evaluation. There was a statistically significant difference in the number of average hospitalization days, drug varieties used, and PIM detection (\\n \\n p\\n <\\n 0.05\\n \\n ), as determined by X2 test. A total of 332 cases of PIM were identified, and 226 cases were detected for the interaction with CNS disease dementia. Multifactor logistic regression analysis showed that male, length of stay ≥15 days, and >10 medication types were risk factors for the occurrence of PIM (\\n \\n p\\n <\\n 0.05\\n \\n ). After clinical supervision and training based on the High-Risk Drug Replacement Program for the Elderly, the rate of irrational medication under medical advice decreased from 34.67% in March 2020 to 14.0% (\\n \\n p\\n <\\n 0.001\\n \\n ) in March 2021. What Is New and Conclusion. There was certain rationality based on the High-Risk Drug Replacement Program for the Elderly, and the rates of selective serotonin reuptake inhibitor, 5-hydroxylamine/norepinephrine re-intake inhibitor, rotenone, quetiapine, and proton pump inhibitor use were improved. These results provide a reference for the continuous improvement of the PIM catalog for elderly patients.\",\"PeriodicalId\":15381,\"journal\":{\"name\":\"Journal of Clinical Pharmacy and Therapeutics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2023-05-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Pharmacy and Therapeutics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2023/1634743\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Pharmacy and Therapeutics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2023/1634743","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}

引用次数: 0

摘要

什么是已知的？在老年住院患者中，潜在的不适当药物（PIM）是一个突出的处方挑战。然而，关于中国中枢神经系统（CNS）疾病患者PIM的可用信息有限。客观的评价和改进老年住院患者合理用药治疗中枢神经系统疾病的方法。方法对老年住院患者（≥65岁）进行了一项回顾性横断面研究年）于2020年3月至2021年3月入住中国郑州市第九人民医院。PIM是根据2019年Beers入院和出院时的标准确定的。2020年3月招募的患者被视为基线组，用于评估2020年6月、2020年9月、2020月和2021年3月中枢神经系统疾病相关药物的PIM。后果共有1500名患者被纳入评估。在平均住院天数、使用的药物品种和PIM检测方面存在统计学显著差异（p 10药物类型是PIM发生的危险因素（p<0.05）。经过基于老年人高风险药物替代计划的临床监督和培训，医疗建议下的不合理用药率从2020年3月的34.67%下降到2021年3月（p<0.001）。新内容和结论。老年人高危药物替代方案具有一定的合理性，选择性5-羟色胺再摄取抑制剂、5-羟胺/去甲肾上腺素再摄入抑制剂、鱼藤酮、喹硫平和质子泵抑制剂的使用率有所提高。这些结果为老年患者PIM目录的持续改进提供了参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Continuous Improvement of the Rational Use of Central Nervous System Disease-Related Drugs in Elderly Inpatients

What Is Known? In elderly inpatients, potential inappropriate medication (PIM) is a prominent prescription challenge. However, there is limited information available regarding PIM in patients with central nervous system (CNS) diseases in China. Objective. To evaluate and improve the rational use of drugs for the treatment of CNS diseases in elderly inpatients. Method. A retrospective, cross-sectional study was conducted among elderly inpatients (≥65 years) admitted to the Ninth People’s Hospital of Zhengzhou in China from March 2020 to March 2021. PIM was identified based on the 2019 Beers criteria at admission and discharge. The patients recruited in March 2020 were considered a baseline group, which was used as a comparison to evaluate PIM of CNS disease-related drugs in June 2020, September 2020, December 2020, and March 2021. Results. A total of 1500 patients were included in the evaluation. There was a statistically significant difference in the number of average hospitalization days, drug varieties used, and PIM detection ( p < 0.05 ), as determined by X2 test. A total of 332 cases of PIM were identified, and 226 cases were detected for the interaction with CNS disease dementia. Multifactor logistic regression analysis showed that male, length of stay ≥15 days, and >10 medication types were risk factors for the occurrence of PIM ( p < 0.05 ). After clinical supervision and training based on the High-Risk Drug Replacement Program for the Elderly, the rate of irrational medication under medical advice decreased from 34.67% in March 2020 to 14.0% ( p < 0.001 ) in March 2021. What Is New and Conclusion. There was certain rationality based on the High-Risk Drug Replacement Program for the Elderly, and the rates of selective serotonin reuptake inhibitor, 5-hydroxylamine/norepinephrine re-intake inhibitor, rotenone, quetiapine, and proton pump inhibitor use were improved. These results provide a reference for the continuous improvement of the PIM catalog for elderly patients.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of Clinical Pharmacy and Therapeutics 医学-药学

CiteScore

4.10

自引率

5.00%

发文量

226

审稿时长

6 months

期刊介绍： The Journal of Clinical Pharmacy and Therapeutics provides a forum for clinicians, pharmacists and pharmacologists to explore and report on issues of common interest. Reports and commentaries on current issues in medical and pharmaceutical practice are encouraged. Papers on evidence-based clinical practice and multidisciplinary collaborative work are particularly welcome. Regular sections in the journal include: editorials, commentaries, reviews (including systematic overviews and meta-analyses), original research and reports, and book reviews. Its scope embraces all aspects of clinical drug development and therapeutics, including: Rational therapeutics Evidence-based practice Safety, cost-effectiveness and clinical efficacy of drugs Drug interactions Clinical impact of drug formulations Pharmacogenetics Personalised, stratified and translational medicine Clinical pharmacokinetics.