潜在不合适的药物与老年人在重症监护和相关因素:一个历史的队列研究研究
Karina Sichieri1, Danilo Donizetti Trevisan2, Ricardo Luís Barbosa3
1Nurse and Doctoral Student, Hospital Universitário (HU), Universidade de São Paulo (USP), São Paulo (SP), Brazil.
Sao Paulo medical journal = Revista paulista de medicina
|August 2, 2023
概括
在重症监护室 (ICU) 的45.8%的老年人中,使用了潜在不合适的药物 (PIM). 诸如更多的药物和更长的停留时间等因素与PIM使用有关,强调需要提高处方安全性.
科学领域:
- 老年医学 老年医学
- 临床药房 临床药房
- 关键护理医学 关键护理医学
背景情况:
- 在重症监护室 (ICU) 使用可能不合适的药物 (PIM) 和相关因素尚未得到充分了解.
- 有限的流行病学数据存在于ICU环境中的PIM,特别是关于老年人.
研究的目的:
- 为了确定PIM在重症监护病房 (ICU) 的发病率.
- 为了确定与使用PIM在ICU的老年患者中相关的因素.
主要方法:
- 在巴西一家医院的重症监护病房 (ICU) 住院的60岁或以上的314名患者的回顾性图表审查.
- 包括奇平方,学生t测试和多变量逻辑回归在内的统计分析被用来确定与PIM相关的因素.
主要成果:
- 根据Beers的标准,在12.8%的药物中发现了潜在不合适的药物 (PIM),整体PIM使用率为45.8%.
- 最常见的PIM包括美托克洛普拉米德,胰岛素,抗精神病药物,NSAID和二zepines.
- 与PIM使用相关的因素包括更多的药物 (OR=1.17),更长的住院时间 (OR=1.07) 和过度的潜在药物相互作用 (OR=2.43).
结论:
- 在ICU中,近一半的老年人接受了潜在不合适的药物 (PIM).
- 在ICU中使用PIM与增加药物负担,更长的ICU停留时间和更高的药物相互作用风险有关.
- 在临床判断的同时,实施明确的处方指南可以提高ICU中的药物安全性和质量.
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