Current status and analysis of polypharmacy among elderly outpatients in a certain hospital
Objective To investigate and analyze the polypharmacy of elderly outpatients in a hospital,and put forward pharmaceutical intervention countermeasures.Methods In 2022,prescriptions of elderly patients admitted to the outpatient clinic were retrieved from the hospital prescription system on a monthly basis,medication reviews were conducted on the patients'prescriptions,and the patients'medication use was investigated through telephone follow-up.Comparison was made on the basic information of two groups of elderly outpatient patients,their knowledge of the drugs used,as well as the common diseases and commonly used drugs in outpatient polypharmacy patients,and the potential inappropriate medication(PIM)in outpatient polypharmacy patients.Results A total of 673 elderly patients were investigated in the outpatient department,of which 188 were polypharmacy patients,accounting for 27.9%.Compared with(72.52±4.93)years,(1.76±1.15)kinds and(3.10±1.20)types in non-polypharmacy group,polypharmacy group had a higher age of(74.61±5.26)years,more diagnosed diseases of(3.35±1.70)kinds,and higher number of drug use of(8.22±2.30)types;but lower 8-Item Morisky Medication Adherence Scale(MMAS-8)scores of(5.32±1.05)points than(6.63±0.52)points in non-polypharmacy patients(P<0.05).The percentage of elderly patients who were aware of drug action,drug dosage and time,adverse drug reactions,contraindications,and precautions were 81.9%,85.6%,75.5%and 64.9%in polypharmacy group,which were significantly lower than 93.0%,95.1%,84.9%and 80.0%in non-polypharmacy group(P<0.05).The survey showed that the 10 most common diseases in elderly patients of polypharmacy group were,in order,sleep disorders 53.7%(101/188),hypertension 31.9%(60/188),diabetes mellitus 22.9%(43/188),dyslipidemia 18.1%(34/188),upper respiratory tract infections 17.0%(32/188),chronic gastritis or ulcers 16.0%(30/188),osteoarthrosis 15.4%(29/188),osteoporosis 12.2%(23/188),chronic lung disease 11.7%(22/188),coronary heart disease 10.6%(20/188).Based on the"Criteria for Determining Potentially Inappropriate Medication Use in Chinese Older Adults(2017 edition)",a total of 175 medication-related PIMs were identified,and no PIMs were found in disease states,of which 45 patients had at least 1 PIM,with an incidence rate of 23.9%,and the top 3 medications in terms of the number of PIMs were clopidogrel with 45 PIMs,eszopiclone with 42 PIMs,and nifedipine with 31 PIMs.Conclusion Polypharmacy is common among elderly outpatients,and the adherence of polypharmacy patients is not high,with a high PIM incidence rate.There is a need to provide corresponding pharmaceutical services for this type of patient to improve medication safety.
PolypharmacyAgedPotentially inappropriate medicationsRational drug useMedication compliance
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