| Objective: Potentially Inappropriate Medication(PIM)screening is very important for the rational drug use in elderly patients.Beers criteria is the most widely used PIM screening tool in the world.The first objective of this study was to systematically review applied studies of 2012 Beers criteria.The second objective was to investigate prevelance and comeleting factors of PIM of in patients in a hospital in China using 2012 Beers criteria and other screening tools.The third objective was to establish the rational drug use screening process for elderly patients in hospital and carry out intervention study to the process.Methods: A systematic literature search on application study of 2012 Beers criteria was carried out.The studies were screened according to the pre-designed inclusion and exclusion criteria,and quality of included studies was assessed.Data were extracted and descriptive systematic review was compeleted.Inpatient medication records of 458 inpatients older than 65 years old from the Geriatric department of a hospital in Guangzhou were evaluated to identify PIM using 2012 Beers criteria,START and STOPP criteria respectively.Multiple logistic regression analysis was used to analyze risk factors of PIM.Subsequently,according to the above criteria,a set of rational drug use screening process for elderly inpatients was developed and an intervention study was conducted.Results: a total of 57 studies related to 2012 Beers criteria application were included in the systematic review.38 studies were of high quality.The results showed that the incidence for PIM was from 5.4% to 95.5%,which varied in different countries or different samples.The main influencing factors of PIM were multiple drug use,age and hospitalization.When compared with other standards,the 2012 Beers critiera had higher detection rate,and were more sensitive than other screeing tools.Medical records of 458 elderly in-patients from one hospital in China were analyzed retroppectively to screen PIM.The average age of geriatric inpatients were 75,and the average number of medications used by patients was 9.According to 2012 Beers criteria,162 disease-independent PIM and 33 disease syndrome-dependent PIM were identified,and 9 cases were treated with medication with caution.According to START/STOPP criteria,22 PIM were identified and 34 potentially prescription omission were identified.Logistic regression analysis showed that age,numbers of medication were the main risk factors of PIM.screening process for PIM screening process was developed.in our hospital from July 1,2017 to September 30,2017.257 elderly hospitalized patients of positive intervention,were found in 36 cases of potentially inappropriate medication application analysis of Beers standard after intervention.The application of STOPP and START standard analysis were found in 32 cases of potentially inappropriate medication.From July 1,2016 to September 30,2016 over the same period of application of Beers standard analysis of potentially inappropriate medication intervention processes were found in 75 cases of potentially inappropriate medication,analysis and application of STOPP and START were found in 58 cases of potentially inappropriate medication.Conclusion: 2012 Beers criteria,is the most widely used tool to screen PIM all over the world,which was effevtive and sensitive to screen PIM.PIM incidence varied in different countries.PIM were commonly identified in geriatric inpatients in the hospital,The results show that the 2012 version Beers criteria detection rate is higher than the 2008 edition STOPP criteria and complementary,and the START criteria can supplement prescription omission,The main influencing factors of PIM detection rate were age and number of drugs used.PIM screening criteria should be advocated to health professionals to prevent PIM.For the rational use of drugs in elderly patients and screening process for clinical research,compared with the process after the intervention of potentially inappropriate medication dropped significantly,this process has practical significance,practical strong,there is no shortage of software. |
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