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首页> 外文期刊>Journal of Clinical Pharmacy and Therapeutics >Inappropriate prescribing in the elderly: a comparison of the Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalized patients.
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Inappropriate prescribing in the elderly: a comparison of the Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalized patients.

机译：老年人处方不当：比较比尔斯（Beers）标准和改善老年急症住院患者老年工具（IPET）的处方。

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BACKGROUND: In appropriate prescribing is a significant and persistent problem in elderly people, both in hospital and the community and has been described in several countries in Europe and also the USA. The problem of inappropriate prescribing has not been quantified in the Republic of Ireland. The most commonly used criteria for the identification of inappropriate prescribing are the Beers' criteria [both independent of diagnosis (ID) and considering diagnosis (CD) - 2003 version]. The Beers' criteria ID includes 48 different categories of either single medications or multiple medications of a similar class identified as inappropriate prescriptions and the Beers' criteria CD contains 19 different categories containing possible drug-disease interactions. A second tool, the improved prescribing in the elderly tool (IPET) has also been validated and used in hospital and community studies and has 14 categories of either explicitly contraindicated medications or possible drug-disease interactions. OBJECTIVES: The primary aim of the study is to measure the incidence of inappropriate prescribing among older community-dwelling individuals presenting to an acute hospital in the Republic of Ireland. A secondary aim of this study was also therefore to compare the efficacy of the above two tools in identifying inappropriate prescribing. METHODS: A prospective, consecutive observational cohort study was carried out over a 4-month period. The setting was an urban-based university hospital acute geriatric medicine assessment unit. Subjects in this study (n = 350) were consecutively screened on admission to hospital (mean age = 80.3 +/- 6.1 years) and all patients had both Beers' criteria ID and CD and IPET applied to their list of prescription drugs on admission, cross-referenced with their list of current active medical diagnosis. RESULTS: The results of the study identified a high rate of inappropriate prescribing among this population of community-dwelling subjects. The total number of inappropriate prescriptions identified using the Beers' criteria (ID) was 148 affecting 121 patients. The Beers' criteria (CD) identified 69 inappropriate prescriptions in 60 patients and the IPET identified 112 inappropriate prescriptions in 78 patients. The Beers criteria (ID and CD combined) identified at least one inappropriate prescription in 34% of subjects and the IPET identified one in at least 22% of subjects. CONCLUSIONS: This study identifies high rates of use of inappropriate medications in community-dwelling elderly presenting with acute illness to hospital. These are comparable with inappropriate prescribing rates identified in previous studies. The revised Beers' criteria (2003) identified more inappropriate prescriptions than the IPET in this population of elders.
机译：背景：在医院和社区中，适当的处方是老年人的一个重大而持久的问题，欧洲和美国的多个国家对此都有描述。爱尔兰共和国尚未对处方不当的问题进行量化。识别不适当处方的最常用标准是比尔斯的标准[均与诊断（ID）和考虑诊断（CD）无关-2003版]。 Beers的标准ID包含48种不同类别的单一药物或类似类别的多种药物，被识别为不合适的处方，Beers's标准CD包含19种不同的类别，其中包含可能的药物-疾病相互作用。第二种工具，改进的老年人处方药（IPET）也已得到验证，并已在医院和社区研究中使用，它具有14种明确禁忌的药物或可能的药物-疾病相互作用。目的：本研究的主要目的是衡量在爱尔兰共和国一家急诊医院就诊的老年社区居民中不适当处方的发生率。因此，本研究的第二个目的是比较上述两种工具在识别不适当处方方面的功效。方法：前瞻性，连续观察性队列研究进行了为期4个月的研究。地点是一家城市大学医院的急性老年医学评估单位。这项研究的受试者（n = 350）在入院时进行了连续筛查（平均年龄= 80.3 +/- 6.1岁），所有患者入院时均将Beers标准ID和CD和IPET应用于他们的处方药清单，与他们当前的积极医学诊断列表进行交叉引用。结果：研究结果表明，在这些社区居民中，不适当的处方率很高。使用比尔斯标准（ID）识别的不适当处方总数为148，影响121位患者。啤酒标准（CD）确定了60位患者的69个不合适的处方，而IPET确定了78位患者的112个不合适的处方。 Beers标准（ID和CD结合使用）在34％的受试者中识别出至少一种不合适的处方，而IPET在至少22％的受试者中识别出一种不合适的处方。结论：本研究发现在社区急诊住院的老年人中，不当药物的使用率很高。这些与以前研究中发现的不适当的开处方率相当。修订后的比尔斯标准（2003年）在这一老年人口中确定了比IPET更不合适的处方。

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