Tỉ lệ sử dụng thuốc không thích hợp ở bệnh nhân cao tuổi nhập viện và những yếu tố liên quan=Prevalence of potentially inappropriate medication use among hospitalized elderly patients and associated factors

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Tác giả: Ái Viên Bàng, Trần Trúc Phương Đặng, Văn Tân Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Y học cộng đồng, 2023

Mô tả vật lý: tr.45664

Bộ sưu tập: Metadata

ID: 477671

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Multi morbidity and polypharmacy are common problems among the older population. They increase the risk of potentially inappropriate medication (PIMs) use and are related to adverse events, falls, re-hospitalization and mortality. Objectives: The study aimed to determine the prevalence and associated factors of PIMs in hospitalized geriatric patients based on the 2019 Beers criteria. Methods: A cross-sectional descriptive study was collected from the medical records of patients 65 years of age or older who were treated at the Cardiovascular Center, Thong Nhat Hospital, HCM City, from December 2020 to June 2021. The PIMs were classified according to the 2019 Beers criteria (AGS) version. We also collected the medication information (quantity, dosage, regime), chronic diseases, Charlson comorbidities index, frailty, history of falls, and re-hospitalization in the last year. Results: A total of 215 eligible patients with 619 prescriptions were included. The mean age was 76.2 ± 7.9 years. The frailty rate (CFS ≥ 5) was 54.9%. The ACCI scores were from 2 to 9. There were 88.4% of the patients took 5 or more medications simultaneously. The prevalence of PIMs use based on the 2019 Beers criteria was 31.2%. The criteria on drugs to avoid, on drug–disease interactions and drug–drug interactions were 87.6%, 10.4%, and 2%, respectively. The common PIMs were long-acting benzodiazepines (27.2%). Logistic regression demonstrated that frailty, polypharmacy, multiple comorbidities, and history of falls were positively associated with PIM use in older adults, p <
0.05. Conclusions: The prevalence of PIMs use was 31.2%. Factors that increase the risk of PIMs were frailty, polypharmacy, history of falls, and rehospitalization.Tình trạng đa bệnh và đa thuốc phổ biến ở người cao tuổi. Điều này không những làm tăng nguy cơ sử dụng thuốc không thích hợp mà còn gây biến cố bất lợi, té ngã, nhập viện và tử vong. Mục tiêu: Nhằm xác định tỉ lệ hiện mắc và yếu tố liên quan đến sử dụng thuốc không thích hợp theo tiêu chuẩn Beers 2019 ở bệnh nhân (BN) cao tuổi điều trị nội trú. Đối tượng và phương pháp nghiên cứu: Mô tả cắt ngang, thu thập từ bệnh án của BN ≥ 65 tuổi nội trú, khoa Tim mạch, BV Thống Nhất TPHCM từ 12/2020 đến 06/2021. Sử dụng thuốc không thích hợp ở bệnh nhân cao tuổi theo tiêu chuẩn Beers 2019 (Hội Lão khoa Hoa Kỳ). Các yếu số có khả năng liên quan đến sử dụng thuốc không thích hợp được thu thập: số lượng thuốc sử dụng, bệnh mạn tính, chỉ số Charlson, suy yếu, tiền sử té ngã, tái nhập viện. Kết quả: Nghiên cứu bao gồm 215 bệnh nhân với 619 lượt kê toa. Tuổi trung bình 76,2 ± 7,9. Tỷ lệ suy yếu (CFS ≥ 5) là 54,9%. Chỉ số bệnh đồng mắc Charlson hiệu chỉnh theo tuổi (ACCI) là từ 2 – 9. Có 88,4% bệnh nhân sử dụng 5 thuốc trở lên. Tần suất sử dụng thuốc không thích hợp theo tiêu chuẩn Beers 2019 là 31,2%. Tiêu chuẩn các thuốc tránh sử dụng, tương tác bệnh-thuốc, tương tác thuốc-thuốc có tỉ lệ lần lượt là 87,6%
10,4%
2%. Sử dụng thuốc không thích hợp gặp nhiều nhất là sử dụng benzodiazepine tác dụng kéo dài chiếm 27,2%. Phân tích hồi quy đa biến cho thấy suy yếu, đa thuốc, tiền sử té ngã, tái nhập viện có liên quan ý nghĩa đến sử dụng thuốc không thích hợp ở BN cao tuổi với p <
0,05. Kết luận: Tỉ lệ sử dụng thuốc không thích hợp theo tiêu chuẩn Beers 2019 là 31,2%. Các yếu tố làm gia tăng nguy cơ sử dụng thuốc không thích hợp là đa thuốc, suy yếu, tiền sử té ngã và tái nhập viện.

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