Evaluation of potentially inappropriate medication in elderly psychiatric patients and the establishment of a nomogram prediction model
Objective To explore the potential inappropriate medication situation of elderly psychiatric patients,and construct a nomogram prediction model to analyze the influencing factors.Methods A retrospective analysis of 389 elderly psychiatric patients in Quzhou Third Hospital were collected from March 2022 to February 2024 to assess the potential for inappropriate drug use.A binary Logistic regression model was used to analyze the independent factors affecting the potential for inappropriate drug use,and a nomogram was used to predict the efficacy of the model.Results Among the 389 psychiatric patients,clozapine tablets,sulpiride tablets and risperidone tablets were commonly used,while the drug with the highest potential risk factor was clozapine tablets.According to the binary Logistic regression analysis,the results showed that the number of combination drugs＞3 kinds,3 kinds of comorbid diseases,some self-paid expenses,and hospitalization days＞14 d were independent factors affecting the potentially inappropriate medication of psychiatric patients(P＜0.05).The nomogram was constructed from independent factors with a C-index of 0.99.After 1 000 internal calibrations,the absolute error of true and predicted agreement was 0.016.By the Bootstrap method,the AUC of the prediction model was 0.870,95％CI(0.815,0.926),and the Hosmer-Lemeshow goodness-of-fit test was 3.749(P＞0.05).Conclusion The length of hospital stay,payment method,number of comorbidities,and types of combined medication are independent factors leading to potentially inappropriate medication in elderly psychiatric patients.Clinically,the above high-risk factors can be used to appropriately adjust patients'medication to reduce the risk of potentially inappropriate medication.
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