Potentially Inappropriate Medication In Older Inpatients: Prevalence,Drug Distribution And Risk Factors

Objective: To investigate the prevalence,drug distribution and influence factors of potentially inappropriate medication(PIM)in older inpatients.The aged exist coexistence of sick and polypharmacy as their own characters,add depression of their organ function,reduction of drug metabolism and excretion,the prevalence of adverse drug reaction(ADR)is high and this enhances hospitalization expenses,mortality and national health insurance costs.The paper tries to analyze the prevalence,drug component and influence factors of PIM in older inpatients to reduce the incidence rate of PIM with effective measures.Method: 699 cases which accordance with the inclusive criteria from Shaanxi Provincial People's Hospital were randomly selected.Based on the Beers Criteria(Version 2015),through Frequency statistical method,Kruskal-Wallis H test,single and multiple logistic regression analysis to describe and conclude.Results: 1.The incidence rate of PIM in older inpatients is 79.5%.The top three are vasodilator substance(45.9%),diuretic(34.8%)and NSAIDs(26.3%).2.According to Kruskal-Wallis H test,compare four different levels of prescribers,the number of PIM in older inpatients is ?2=6.115,P=0.106.3.According to logistic regression analysis(Forward:LR),variables which enter the models are combination drug quantity(OR=2.779,P=0.000),inpatient departments(OR=0.489,P=0.001)and health care types(OR=1.219,P=0.048),variables which are refused into the models are gender(P=0.729),age(P=0.376),the number of diseases(P=0.663)and hospital stay(P=0.213).Conclusion: 1.The incidence rate of PIM in older inpatient is high,mainly distributed in vasodilator substance,diuretic and NSAIDs.2.There are no statistic differences between four different levels of prescribers and the number of PIM in older inpatients.3.Health care types,combination drug quantity and inpatient departments are the influence factors of PIM and higher combination drug quantity and Medicare reimbursed are more likely arising PIM.Compared surgical unit,internal medicine unit have higher risk of PIM.4.There are no relations among gender,age,the number of diseases and hospital stay with PIM in older inpatients.