目的 探討心血管內(nèi)科老年患者出院帶藥處方的情況，并對(duì)其影響因素進(jìn)行分析，以提高老年患者合理用藥的水平。方法 回顧性分析2023年1～12月從泰州市人民醫(yī)院心血管內(nèi)科出院的老年患者，根據(jù)2023年版Beers標(biāo)準(zhǔn)及《中國(guó)老年人潛在不適當(dāng)用藥判斷標(biāo)準(zhǔn)（2017年版）》，應(yīng)用多因素Logistic回歸分析，對(duì)影響潛在不適當(dāng)用藥（PIM）的因素進(jìn)行分析。通過(guò)對(duì)患者所在病房是否有臨床藥師參與進(jìn)行分組，比較PIM的發(fā)生率。結(jié)果 納入老年患者共1 982例，Beers標(biāo)準(zhǔn)篩選出PIM病例1 518例（76.59%），《中國(guó)老年人潛在不適當(dāng)用藥判斷標(biāo)準(zhǔn)》篩選出PIM病例1 276例（64.38%）；多因素Logistic回歸分析結(jié)果表明，按照2023年版Beers標(biāo)準(zhǔn)和《中國(guó)老年人潛在不適當(dāng)用藥判斷標(biāo)準(zhǔn)（2017年版）》，疾病種數(shù)、患者用藥的種類均是影響PIM發(fā)生的因素（P＜0.05）。臨床藥師干預(yù)后，PIM發(fā)生率降低（P＜0.05）。結(jié)論 疾病種數(shù)、用藥種類是影響PIM發(fā)生的因素，臨床醫(yī)師及藥師應(yīng)該尤為重視多重慢病患者，降低老年人多重用藥的危險(xiǎn)。臨床藥師對(duì)老年患者的出院帶藥進(jìn)行用藥管理，有利于降低PIM的發(fā)生率，促進(jìn)臨床合理用藥。

Objective To explore the situation of elderly patients discharged from cardiovascular medicine department with medication prescriptions and to analyze the influencing factors in order to improve the rational use of medication in elderly patients. Methods Elderly patients discharged from the Department of Cardiovascular Medicine of Taizhou People's Hospital from January to December 2023 were retrospectively analysed. Multifactorial logistic regression analysis was applied to analyse the factors affecting PIM according to the 2023 edition of the Beers criteria and the Criteria for Determining Potentially Inappropriate Medication Use in the Elderly in China (2017 edition). The incidence of PIM was compared by grouping patients by whether or not their wards involved clinical pharmacists. Results Among 1 982 elderly patients, 1 518 (76.59%) cases of PIM were screened by Beers' criteria, and 1 276 (64.38%) cases of PIM were screened by the Criteria for Judging Potentially Inappropriate Medication Use in the Elderly in China. The results of multifactorial logistic regression analyses showed that the number of disease species and the type of medication used by the patient were factors influencing the occurrence of PIM according to the 2023 edition of the Beers Criteria and the Criteria for Determining the Potentially Inappropriate Use of Medication in the Elderly in China (P < 0.05). After the intervention of clinical pharmacists, the incidence of PIM was reduced (P < 0.05). Conclusions The number of diseases and types of medication are factors that affect the occurrence of PIM, and clinicians and pharmacists should pay special attention to patients with multiple chronic diseases to reduce the risk of multiple medication use in the elderly. Clinical pharmacists' medication management for elderly patients discharged with medication is conducive to reducing the incidence of PIM and promoting rational clinical use of medication.

R972

江蘇省藥學(xué)會(huì)-恒瑞醫(yī)院藥學(xué)基金（H202025）