对心力衰竭患者的潜在不适合的药物:从2012年到2022年的全国性回顾性研究
Tomiko Sunaga1,2, Shunichi Ishii2,3, Michiru Nagao2,4
1Clinical Epidemiology, Division of Applied Pharmaceutical Education and Research, Hoshi University, Tokyo, Japan.
Journal of pharmaceutical policy and practice
|December 11, 2025
概括
对心力衰竭 (HF) 患者的潜在不合适药物 (PIM) 在日本十年来下降. 这项研究分析了趋势,并发现PIM处方的下降,表明改善了药物管理.
科学领域:
- 老年医学 老年医学
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 人口老龄化需要对心力衰竭 (HF) 患者进行谨慎的药物管理.
- 潜在不合适的药物 (PIMs) 对患有HF的老年人构成风险.
- 在日本,PIM降低策略对HF患者的有效性仍在调查中.
研究的目的:
- 在过去的十年里,调查日本住院高风暴患者的PIM处方趋势.
- 分析HF患者的特征及其PIM处方模式.
- 评估实施的PIM反制措施的影响.
主要方法:
- 来自日本心血管疾病登记数据库和诊断程序组合数据库的数据分析.
- 包括1,452,034名在2012年4月至2022年3月期间被诊断患有HF的18岁以上的住院患者.
- 研究的分层分为三个时期:2012-2015年,2016-2019年和2020-2022年.
主要成果:
- 在典型PIM的处方中观察到显著的下降趋势,包括二类药物,抗焦虑药物,α-葡萄糖酶抑制剂, thiazolidines,硫尿素,非二二胺抗体,狄戈辛,非类固醇抗炎药物,抗胆固醇药物和β2激动剂 (P <0.01对所有).
- 在住院期间开始的PIM处方很少在患者出院后继续使用.
- 该研究确定了特定的PIM类,在研究期间使用量下降.
结论:
- 在日本,在住院高炎患者的典型PIM使用在过去十年中下降.
- 医疗保健提供者应专注于优化药物治疗方案,以尽量减少HF患者的PIM.
- 对HF患者的PIM监测可能成为未来的关键安全指标.
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