Investigation of irrational drug use in elderly patients and analysis of influence factors of potentially inap-propriate medications andinfluence factors analysis of potential inappropriate medication in geriatric patients in senile people / 医学研究生学报

ABSTRACT

Objective The proportion of multiple drugs and the irrational use of drugs increased significantly in the elderly patients (over 80 years). This study aimed to investigate the occurrence of potentially inappropriate medication (PIM) and analyzed the possible reasons related to PIM in elderly patients. Methods In this study,918 cases from Cadre Ward I of Research Center for Geriatrics of Nanjing General Hospital of Nanjing Military Region were selected from January to December in 2016. According to the Beers Criteria (Version 2015),we evaluated PIM in four subtypes,type 1 that is not related to the state of disease in elderly patients, type 2 that is related to the state of disease in elderly patients,type 3 which should be used carefully,and type 4 which is the inappropriate combination of non-anti-infective Drugs. The PIM influence factors were analyzed by logistic regression analysis. Results There are 521 cases (56.75%) of type 1 PIM. The first 3 drugs are Short and medium acting benzodiazepams,PPI and long acting benzodiazepams. There are 206 cases (22.4%) of type 2 PIM. The first 2 drugs are drugs associated with insomnia (oral hyperemia, stimulants, theo-phylline and caffeine) and drugs associated with dementia or cognitive impairment (anti-cholinergic drugs and H2 receptor antago-nists). There are 834 cases (90.85%) of type 3 PIM,which should be used carefully and 45 cases(4.90%) of type 4 PIM.45 cases (4.90%) of non-anti-infective drugs should be avoid or reduced as much as possible in consideration of renal function. The number of combined drug use(OR=5.331,95% CI3.549-8.009),the age(OR=1.171,95% CI1.093-1.249),the Chalson's comorbidity index (OR=1.964,95% CI1.477-2.450) are risk factors of PIM. Conclusion The incidence of potentially inappropriate use of drugs is high among the elderly patients. Reducing the number of combined drugs is an important measure to avoid the occurrence of PIM in elderly patients.