Analysis of Potentially Inappropriate Medications and Influencing Factors in Elderly Patients in the Department of Cardiology in a Hospital
Objective To evaluate the potentially inappropriate medications(PIMs)among elderly patients in the Department of Cardiology in the hospitals,and to analyze the influencing factors of PIMs.Methods The elderly patients discharged from the Department of Cardiology in the hospital from April to December 2021 were extracted by the hospital information system.The patients'name,gender,age,length of hospital stay,diagnosis,medication,relevant test data and incidence of adverse reactions were collected.Based on the Criteria of Potentially Inappropriate Medications for Older Adults in China(2017 Edition),the occurrence of drug-related and disease status-related PIMs were evaluated,and its characteristics were summarized.The multivariate Logistic regression analysis was used to evaluate the risk factors of PIMs.Results A total of 222 patients were enrolled,including 103 males and 119 females,aged in the range of 60-96 years,with an average of 75(68,81)years.The length of hospital stay was in the range of 3-22 d,with an average of 9(7,11)d;there were 1667 diagnoses,with an average of 7(6,9)diagnoses;the patients used 5-29 varieties of drugs,with an average of 14(11,18)varieties.There were 215 cases of PIMs,of which 213(489 case times)were related to the drugs,involving 185 cases of A-level and 102 cases of B-level warning drugs(74 cases of both),and 21 varieties of drugs were involved.There were 65 cases(85 case times)of disease status-related PIMs,involving nine kinds of disease statuses,including eight kinds of A-level and one kind of B-level warning diseases,respectively.The univariate analysis showed that the influencing factor of drug-related PIMs was only the variety of medication.The influencing factors of disease status-related PIMs were age,variety of medication and diagnosis number(P<0.05).The multiple Logistic regression analysis showed that the variety of medication[OR=1.304,95%CI(1.073,1.585),P=0.008]was the influencing factor for drug-related PIMs;the age[OR=0.951,95%CI(0.915,0.989),P=0.012],diagnosis number[OR=1.134,95%CI(1.004,1.281),P=0.043]and variety of medication[OR=1.078,95%CI(1.013,1.147),P=0.018]were the influencing factors for disease status-related PIMs.Conclusion The incidence of PIMs in elderly patients in the Department of Cardiology of this hospital is high.The patients'age,variety of medication and diagnosis number are all related to the occurrence of PIMs.Clinical physicians and pharmacists need to strengthen their risk awareness to improve the rationality of patients'medication and decrease the occurrence of PIMs.
potentially inappropriate medicationDepartment of Cardiologyelderly patientrational drug usepharmaceutical care