To Evaluate The Potentially Inappropriate Medication With Beers Criteria In Hospitalized Elderly Patients

Objective: The elderly often have more than one disease, which leads topolypharmacy,potentially inappropriate medication(PIM). potentially inappropriatemedication cause adverse drug reaction(ADR),adverse drug events(ADEs), increasedmedical expenses hospitalization rates and mortality.To study the consumption ofpotentially inappropriate medication among439hospitalized patients aged65yearsbased on the Beers Criteria published in2012, aimed at evaluating potentiallyinappropriate medication uses of the elderly patients, and inquiring into possible factorsaffecting the drug uses of senile patients.Methods：439(January and December of2013) inpatients were scheduled from theDepartment of Geriatrics in the First Affiliated Hospital of Dalian Medical University.The aged between65-95years old, with an average age of (79.56±7.12)years old, therewere262male patients with a mean age (79.56±7.12),177female patients with a meanage of (77.12±6.66). All patients were in hospital2d to30d, patients with malignanttumors or with hospitalization history in the First Affiliated Hospital of Dalian MedicalUniversity were excluded. Judging PIM based on Beers Criteria published in2012.Judging other PIM that are not included in the Beers Criteria by the theory ofpharmacology and related literature. Multiple logistic regression analysis, univariateanalysis(Log-rank test),multivariate analysis (Cox regression,backward:LR) were usedto analyze the prognostic significance of clinical and pathological characteristics.Results：9.01±4.93kinds of medicine had been taken per inpatient, which had adivergence between24at most and0at least.Among the439cases,79cases(18.00%)used fewer than5kinds,82%of the cases took more than5kinds of drugs,191cases(43.51%) using5-10kinds,160cases(36.45%) using11-20kinds, and8cases(1.82%) more than20kinds.Traditional Chinese medicine preparations were applied by45inpatients(10.25%), including preparations such as Ligustrazine Phosphate Injection,Ginkgo leaf extract, ShenSongYangXin capsule. In accordance with the Beers Criteria,76objects had taken82person-doses of PIMs totally,70objects(15.95%)used one PIM,6objects (1.37%) used two PIMs.74cases of PIMs are unconcerned in diagnosis ordisease. The drugs of PIM with the highest frequency were alprazolam, estazolam,amiodarone and sandy lamicta l.8cases(1.82%)of PIMs were related to diagnosis ordisease.66cases (15.03%) used drugs that need to be used with caution in older adults.23cases (5.24%) were other PIMs that do not included in Beers Criteria，for the maincause of drug interactions. Logistic regression analysis showed that kinds of drugs, maleentered into the regression equation, and their p＜0.05.Conclusion: Beers criteria in evaluating PIMs have important application value,but they can not replace professional judgment. Many factors lead to the elderlypatients’ potentially inappropriate medication. We should keep strict control over andmake use of these factors, reduce the occurrence of adverse drug reactions.