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首页> 外文期刊>Scandinavian journal of primary health care. >Clinical impact of potentially inappropriate medications during hospitalization of acutely ill older patients with multimorbidity
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Clinical impact of potentially inappropriate medications during hospitalization of acutely ill older patients with multimorbidity

机译：急性多发性老年患者住院期间可能不适当用药的临床影响

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Objective: To identify potentially inappropriate medications (PIMs), to compare drug changes between geriatric and other medical wards, and to investigate the clinical impact of PIMs in acutely hospitalized older adults.Setting and subjects: Retrospective study of 232 home-dwelling, multimorbid older adults (aged75 years) acutely admitted to Vestfold Hospital Trust, Norway.Main outcome measures. PIMs were identified by Norwegian general practice (NORGEP) criteria and Beers' 2012 criteria. Clinical correlates were laboratory measures, functional and mental status, physical frailty, and length of stay.Results: Mean (SD) age was 86 (5.7) years, and length of stay was 6.5 (4.8) days. During the stay, the mean number of drugs used regularly changed from 7.8 (3.6) to 7.9 (3.6) (p=0.22), and drugs used pro re nata (prn) changed from 1.4 (1.6) to 2.0 (1.7) (p<0.001). The prevalence of any PIM changed from 39.2% to 37.9% (p=0.076), while anticholinergics and benzodiazepines were reduced significantly (p0.02). The geriatric ward reduced drug dosages (p<0.001) and discontinued PIMs (p<0.001) significantly more often than other medical wards. No relations between number of PIMS and clinical outcomes were identified, but the concomitant use of 3 psychotropic/opioid drugs was associated with reduced hand-grip strength (p0.012).Conclusion: Hospitalization did not change polypharmacy or PIMs. Drug treatment was more appropriate on the geriatric than other medical wards. No clinical impact of PIMs was observed, but prescribers should be vigilant about concomitant prescription of 3 psychotropics/opioids.
机译：目的：确定可能不适当的药物（PIMs），比较老年病房和其他病房之间的药物变化，并研究PIMs在急性住院的老年人中的临床影响。地点和受试者：对232例家庭，多病态老年人的回顾性研究挪威Vestfold Hospital Trust紧急收治的成年人（75岁）。主要结局指标。 PIM是通过挪威通用（NORGEP）标准和Beers'2012标准确定的。临床相关因素包括实验室检查，功能和精神状态，身体虚弱以及住院时间。结果：平均（SD）年龄为86（5.7）岁，住院时间为6.5（4.8）天。在住宿期间，经常使用的平均药物数量从7.8（3.6）更改为7.9（3.6）（p = 0.22），而prona（prn）使用的药物从1.4（1.6）更改为2.0（1.7）（p <0.001）。任何PIM的患病率从39.2％变为37.9％（p = 0.076），而抗胆碱能药和苯二氮卓类药物的患病率显着降低（p0.02）。老年病房比其他医疗病房更频繁地减少药物剂量（p <0.001）和停用PIM（p <0.001）。没有发现PIMS的数量与临床结局之间的关系，但同时使用3种精神药物/阿片类药物与降低手握力有关（p0.012）。结论：住院治疗并没有改变多药店或PIM。药物治疗在老年病房比其他医疗病房更合适。未观察到PIM的临床影响，但开药者应警惕3种精神药物/阿片类药物的并用处方。

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