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乌鲁木齐6家养老机构老年人潜在不适当用药情况及影响因素分析
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| 篇名： | 乌鲁木齐6家养老机构老年人潜在不适当用药情况及影响因素分析 |
| TITLE： | Analysis of potentially inappropriate medication and influencing factors among the elderly in six nursing homes in Urumqi |
| 摘要： | 目的 基于3种潜在不适当用药（PIM）筛查工具调查乌鲁木齐市养老机构老年人PIM的发生情况及影响因素，并比较不同工具的适用性。方法采用横断面研究设计，于2021年5月至2023年9月选取乌鲁木齐市6家养老机构的老年人作为研究对象。收集老年人的人口学特征、疾病负担及用药记录，分别应用中国PIM标准（2024年版）、美国老年医学会（AGS）Beers标准（2023年版）、老年人潜在不适当处方筛查工具（STOPP）/处方遗漏筛查工具（START）（2023年版）进行PIM筛查。采用Fleiss’sKappa检验评估3种筛查工具的一致性，采用多因素Logistic回归分析PIM发生的影响因素。结果中国PIM标准筛查PIM的发生率为47.4%（323/682），AGSBeers标准为43.4%（296/682），STOPP标准为50.9%（347/682）。3种筛查工具的一致性较低（Fleiss’sKappa＝0.12，P＜0.001）。多因素Logistic回归分析显示，3种筛查工具均提示多重用药、服用阿司匹林、服用精神类药物是养老机构老年人PIM发生的独立危险因素（OR均大于1，P＜0.05）。结论乌鲁木齐市养老机构老年人PIM发生率较高；多重用药、服用阿司匹林、服用精神类药物是PIM发生的共同独立危险因素；3种筛查工具的筛查结果存在差异，一致性较低；中国PIM标准可作为养老机构PIM筛查的一线工具。 |
| ABSTRACT： | OBJECTIVE To investigate the prevalence and influencing factors of potentially inappropriate medication （PIM） among the elderly in nursing homes in Urumqi based on three PIM screening tools， and to compare the applicability of different tools. METHODS A cross-sectional study design was adopted. Elderly individuals from six nursing homes in Urumqi were selected as the research subjects from May 2021 to September 2023. Demographic characteristics， disease burden and medication records of the elderly were collected. PIM screening was performed using the Chinese PIM criteria （2024 edition）， the American Geriatrics Society （AGS） Beers criteria （2023 edition）， and the Screening Tool of Older Person’S Prescriptions（STOPP）/Screening Tool to Alert to Right Treatment（START） （2023 edition）. Fleiss’s Kappa test was used to assess the consistency among the three screening tools， and multivariate Logistic regression was used to analyze the influencing factors of PIM. RESULTS The prevalence of PIM screened by the Chinese PIM criteria was 47.4% （323/682）， by the AGS Beers criteria was 43.4% （296/682）， and by the STOPP criteria was 50.9% （347/682）. The consistency among the three screening tools was low （Fleiss’s Kappa＝0.12， P ＜0.001）. Multivariate Logistic regression analysis showed that all three screening tools indicated that polypharmacy， aspirin use and psychotropic drug use were independent risk factors for PIM among elderly in nursing houses （all OR＞1， P ＜0.05）. CONCLUSIONS The prevalence of PIM among the elderly in nursing homes in Urumqi is relatively high. Polypharmacy， aspirin use and psychotropic drug use are common independent risk factors for PIM. There are differences in screening results among the three tools with low consistency. The Chinese PIM criteria can serve as a first-line tool for PIM screening in nursing homes. |
| 期刊： | 2026年第37卷第12期 |
| 作者： | 李乾辉；王建华；杨尚杰；吴彪；朱莉娜；彭东玲；高慧；罗春林；秦占磊；姑丽米热·艾力；王宁宁；艾则孜江·艾尔肯；王钰博 |
| AUTHORS： | LI Qianhui，WANG Jianhua，YANG Shangjie，WU Biao，ZHU Lina，PENG Dongling， GAO Hui，LUO Chunlin，QIN Zhanlei，Gulmira Eli，WANG Ningning，Aizezijiang Aierken，WANG Yubo |
| 关键字： | 潜在不适当用药; 老年人; 养老机构; 中国PIM标准; AGS Beers标准; STOPP标准 |
| KEYWORDS： | potentially inappropriate medication; the elderly; nursing homes; Chinese PIM criteria; AGS Beers criteria; STOPP criteria |
| 阅读数： | 2 次 |
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