| Objectives 1.To investigate the potentially inappropriate medication(PIMs)and their influence factors in elderly inpatients with diabetes;2.To investigate the suitability of patient' attitudes towards deprescribing questionnaire(PATD)in the context of Chinese sociocultural environment and health care system.Methods This research is divided into two parts: 1the first part 1was investigated the potential inappropriate medication in elderly inpatients with diabetes,the second part was translation of patient' attitudes towards deprescribing questionnaire.1.Part one: The medical record date of diabetes patients ?65 years,who were discharged from the Department of a Class ? Grade ?hospital in zhengzhou between January 2015 and March 2016,were collected and retrospectively studied.The PIMs were evaluated according to the 2015 Beers criteria.Multivariate logistic regression were performed to analyze the influence factors.2.Part two1: Based on the process1 of translation,1back-translation,1culture adaption,1and preliminary test,formed the1 Chinese version of PATD questionnaire,which consisted of 22 items in six dimensions.Choosing a total of 246 elderly diabetes patients,using the homogeneity reliability to evaluate the internal consistency degree of this form;using exploratory factor analysis(EFA)1 to test the structural validity of the scale,using the content validity index(CVI)1 to compute the expert content validity after the researchers obtained the permission.Results 1.Part one: A total of 697 patients were enrolled in this study,558 patients(80.1%)receives PIMs listed in the 2015 Beers criteria,69.6% patients had the situation of inappropriate medication,7.6% patients were associated with inappropriate medication due to disease condition,34.9% patients were associated with inappropriate medication to be used with caution in older adults;18.8% patients were associated with inappropriate medication due to the drug-drug interactions;10.4% patients were associated with inappropriate medication which should avoided or reduced dosage with Kidney Function.Drugs with frequency of PIMs were proton pump inhibitors,benzodiazepines,short-acting insulin,et al.Logistic regression analysis showed that the risk factors of PIMs were age(?80),drugs categories(?10),hospitalization time,and non-Endocrinology inpatients.2.Part two: The overall Cronbach'? was 0.816,the Cronbach'? of the four dimensions ranged from 0.646 to 0.759,and the test-retest1 reliability after one week was 0.729~0.763.The I-CVIs of Chinese version of PATD questionnaire1 were ranged from 0.83 to 1.00,and1 S-CVI was 0.964.By exploratory factor analysis,six common factors were extracted;the cumulative variance of the six factors was 64.221%,and two items had two factors loading >0.4;correlation coefficient between the factor score of two items and their dimension score were <0.5.Conclusion 1.The prevalence of PIM in elderly inpatients with diabetes was high,the comprehensive drug assessment and personnel training are needed,to ensure medication safety.2.The modified PATD questionnaire had acceptable validity and reliability,which can be used as a tool for assessing the effectiveness of education. |
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