一项关于社区老年人潜在的不适当药物使用和各种原因死亡率的前性研究
Liat Orenstein1,2, Angela Chetrit1, Keren Laufer3
1Public Health Research Center, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat-Gan, Israel.
Journal of the American Geriatrics Society
|August 11, 2025
概括
潜在不适当的处方 (PIP),包括潜在不适当的药物 (PIM) 和处方遗漏 (PPO),显著增加了老年人的长期死亡风险. 在实践中解决健康个体和PPO中的PIM对于改善结果至关重要.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 潜在不合适的处方 (PIP),包括潜在不合适的药物 (PIM) 和处方遗漏 (PPO),在老年人中很常见.
- PIP与不良健康结果有关,但其对长期死亡率的影响需要进一步调查.
研究的目的:
- 检查PIM和PPO与社区老年人长期死亡率之间的关联.
主要方法:
- 一项纵向前性队列研究追踪了1210名参与者的死亡率,直到2022年3月.
- 使用Beers和STOPP/START v3标准确定了PIM和PPO.
- 考克斯的比例危险和细灰模型评估了与所有原因和非癌症死亡率的关联,并对共变量进行了调整.
主要成果:
- 81.2%的参与者有>1个PIP问题;52.6% (酒) 和45.0% (STOPP) 有PIM;59.3%有PPO.
- ≥2 PIM增加了所有原因的死亡率 (酒:HR 1.31;STOPP:HR 1.25) 和非癌症死亡率 (1.4倍).
- ≥2个PPO增加了全因死亡率 (HR1.84) 和非癌症死亡率 (1.3-2.0倍),男性的相关性更强.
结论:
- PIP是普遍存在的,并且与社区居住的老年人长期死亡率的增加有关.
- 在更健康的老年人中准PIM和减少临床实践中的PPO是关键干预措施.
- 建议制定性别特定的药物指南.
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