본문 바로가기
KERD
논문KCI 등재

3년간 치료를 지속한 정신과 외래 노인 환자에서의 다제요법에 대한 연구

A Study on Polypharmacy in the Elderly Psychiatric Outpatients with Persistent Treatments for 3 years

정인과|유해선
대한노인정신의학회 (Korean Association For Geriatric Psychiatry)|2010.06|노인정신의학 (Journal of Korean Geriatric Psychiatry)|제14권 제1호|pp. 50-57

1

조회

0

다운로드

1

인용

0

참고문헌

키워드

The elderly·Polypharmacy·Psychiatric drugs노인·다제요법·정신과적 약물

초록

Objectives：The objective of this study was to investigate the prescription trends for the elderly psychiatric outpatients at a university hospital. Methods：We performed a retrospective study based on medical records. Data on 146 elderly patients (65 years and older) diagnosed with psychiatric disorders according to ICD-10 from January 2005 to March 2008 were collected. Analyses were performed regarding demographic characteristics, prevalence of polypharmacy, and the doses and types of drugs prescribed. Results：In 146 subjects, the mean age was 76.14±5.21. More than five types of drugs were prescribed to 49.5% of the patients in 2008. The percentage of stable users (those without changes in the category of polypharmacy for 3 years) was 69.8%. Each patient received an average of 4.20±1.50 kinds of drugs in 2005 and 4.02±1.77 in 2008. The average dose of drugs was 6.1±3.50 in 2005 and 6.49±4.09 in 2008, and the difference was not statistically significant. The average number of types of psychiatric drugs prescribed to the patients decreased from 2.37±0.86 in 2005 to 2.17±0.87 in 2008 (p<0.05). Conclusion：Although practice of polypharmacy showed a slow increase over the 3 years from 2005 to 2008, almost half of the elderly patients we studied received multiple drugs. Since polypharmacy can increase drug-drug interactions and adverse effects in the elderly, appropriate drug monitoring and careful prescription are necessary.

Abstract

Objectives：The objective of this study was to investigate the prescription trends for the elderly psychiatric outpatients at a university hospital. Methods：We performed a retrospective study based on medical records. Data on 146 elderly patients (65 years and older) diagnosed with psychiatric disorders according to ICD-10 from January 2005 to March 2008 were collected. Analyses were performed regarding demographic characteristics, prevalence of polypharmacy, and the doses and types of drugs prescribed. Results：In 146 subjects, the mean age was 76.14±5.21. More than five types of drugs were prescribed to 49.5% of the patients in 2008. The percentage of stable users (those without changes in the category of polypharmacy for 3 years) was 69.8%. Each patient received an average of 4.20±1.50 kinds of drugs in 2005 and 4.02±1.77 in 2008. The average dose of drugs was 6.1±3.50 in 2005 and 6.49±4.09 in 2008, and the difference was not statistically significant. The average number of types of psychiatric drugs prescribed to the patients decreased from 2.37±0.86 in 2005 to 2.17±0.87 in 2008 (p<0.05). Conclusion：Although practice of polypharmacy showed a slow increase over the 3 years from 2005 to 2008, almost half of the elderly patients we studied received multiple drugs. Since polypharmacy can increase drug-drug interactions and adverse effects in the elderly, appropriate drug monitoring and careful prescription are necessary.

참고문헌 (37)

  1. 통계청, "2008 고령자 통계", ~ (2008)
  2. Hayes BD, "Polypharmacy and the geriatric patient", Clin Geriatr Med, 23, pp.371~390 (2007)
  3. Prybys KM, "Deadly drug interactions in emergency medicine", Emerg Med Clin North Am, 22, pp.845~863 (2004)
  4. Fulton MM, "Polypharmacy in the elderly: a literature review", J Am Acad Nurse Pract, 17, pp.123~132 (2005)
  5. Veehof L, "The development of polypharmacy. A longitudinal study", Fam Pract, 17, pp.261~267 (2000)
  6. Bjerrum L, "Methods for estimating the occurrence of polypharmacy by means of a prescription database", Eur J Clin Pharmacol, 53, pp.7~11 (1997)
  7. Bikowski RM, "Physician-patient congruence regarding medication regimens", J Am Geriatr Soc, 49, pp.1353~1357 (2001)
  8. Jorgensen T, "Prescription drug use,diagnoses, and healthcare utilization among the elderly", Ann Pharmacother, 35, pp.1004~1009 (2001)
  9. Ballentine NH, "Polypharmacy in the elderly: maximizing benefit,minimizing harm", Crit Care Nurs Q, 31, pp.40~45 (2008)
  10. Lindley CM, "Inappropriate medication is a major cause of adverse drug reactions in elderly patients", Age Ageing, 21, pp.294~300 (1992)
  11. Schafer SL, "Prescribing for seniors: it’s a balancing act", J Am Acad Nurse Pract, 13, pp.108~112 (2001)
  12. Sudeep Gill BL, "How to Avoid Danagerous Medication Precribing Practice", Geriatrics & Aging, 4, pp.18~19 (2001)
  13. Rancourt C, "Potentially inappropriate prescription for older patients in long-term care", BMC geriatrics, 15, pp.4~9 (2004)
  14. Kim HS, "A Drug Use and the Related Factors of the Elderly Persons in a Gwang ju Area", Journal of Korean Public Health Association, 1, pp.69~79 (2001)
  15. Kim BR, "A Survey on Medicine Use in the Elderly", Journal of Korean Gerontological Nursing, 3, pp.208~216 (2001)
  16. Lym SM, "A Study of Prescribed drugs and Over-the-counter drugs in the Elderly", Ewha Womans University, ~ (2005)
  17. Korean Food and Drug Administration, "Drug use pattern and evaluation for appropriateness in geriatric patients", ~ (2004)
  18. Sohn HS, "Strategy for appropriate drug use in the elderly in Korea", Research Institute of Pharmaceutical Sciences at Sookmyung Women’s University, ~ (2005)
  19. "Med Arh", 2004, 138~141
  20. "Health insurance review and assessment service. 2004 Health Insurance Review Statistics Indices", ~ (2004)
  21. Yoon JL, "Importance of Individualized physician system for the Quality Improvement in Primary Geriatric Care", Korean Journal of Family Medicine, 27, pp.501~504 (2006)
  22. Montamat SC, "Overcoming problems with polypharmacy and drug misuse in the elderly", Clin Geriatr Med, 8, pp.143~158 (1992)
  23. Choi YS, "Survey on Current Situdations of Geriatric Patients’ Medication and Drug Interactions Based on Prescriptions", Journal of the Pharmaceutical Society of Korea, 47, pp.390~397 (2003)
  24. National Health Insurance, "Comparison of Health insurance system between Korea and United States", ~ (2010)
  25. Hurwitz N, "Predisposing factors in adverse reactions to drugs", Br Med J, 1, pp.536~539 (1969)
  26. Johnson JA, "Drug-related morbidity and mortality. A cost-of-illness model", Arch Intern Med, 155, pp.1949~1956 (1995)
  27. Klein U, "The frequency of adverse drug reactions as dependent upon age, sex and duration of hospitalization", Int J Clin Pharmacol Biopharm, 13, pp.187~195 (1976)
  28. Yoon JL, "Appropriate Pharmacotherapy in Elderly Patinets", Journal of Korean Medical Association, 1, pp.24~33 (2005)
  29. Hutchinson TA, "Frequency, severity and risk factors for adverse drug reactions in adult out-patients: a prospective study", J Chronic Dis, 39, pp.533~542 (1986)
  30. Schuler J, "Polypharmacy and inappropriate prescribing in elderly internal-medicine patients in Austria", Wien Klin Wochenschr, 120, pp.733~741 (2008)
  31. Hilmer SN, "Clinical pharmacology in the geriatric patient", Fundam Clin Pharmacol, 21, pp.217~230 (2007)
  32. Junius-Walker U, "Prevalence and predictors of polypharmacy among older primary care patients in Germany", Fam Pract, 24, pp.14~19 (2007)
  33. 조민경, "고령 환자의 polypharmacy 현황 분석", 병원약사회지, 22(3), pp.1~8 (2005), 한국병원약사회
  34. Fick DM, "Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts", Arch Intern Med, 163, pp.2716~2724 (2003)
  35. Woerner MG, "Neuroleptic treatment of elderly patients", Psychopharmacol Bull, 31, pp.333~337 (1995)
  36. Madhusoodanan S, "Safety of benzodiazepines in the geriatric population", Expert Opin Drug Saf, 3, pp.485~493 (2004)
  37. Fugh-Berman, "Herb-drug interactions", Lancet, 355, pp.134~138 (2000)

관련 논문AI추천

정신건강의학과 외래치료를 받고 있는 노인환자들의 다중약물요법과 연관된 약물사용양상과 요인들김현, 이강준, 정연경대한신경정신의학회 · 신경정신의학2012 · 제51권 제5호한국의 외래노인환자에서 약물사용의 경향 및 explicit criteria에 의한 적절성평가남진선, 신완균, 오정미한국임상약학회 · 한국임상약학회지2005 · 제15권 제2호Prescription Patterns for Patients with Schizophrenia in Korea: A Focus on Antipsychotic Polypharmacy강민희, 김철응, 김희윤, 배재남, 이정섭, 이희원, 정승호대한정신약물학회 · Clinical Psychopharmacology and Neuroscience2014 · 제12권 제2호노인환자의 항정신병 약물 원외처방 내역에 미친 영향 요인 분석김유정, 동재용, 이태훈, 이현지한국임상약학회 · 한국임상약학회지2021 · 제31권 제4호외래 노인환자의 약물사용현황 분석 및 적절성 평가김향숙, 신은정, 우희경, 이혜숙, 임정미한국병원약사회 · 병원약사회지2014 · 제31권 제5호노인요양시설 노인의 다약제 복용(Polypharmacy)과 부적절한 약물사용 실태강숙, 김정선보건의료산업학회 · 보건의료산업학회지2013 · 제7권 제3호

이 간행물의 다른 논문 (8건)

노인학대박인수, 김신겸pp. 3-8치매 환자에서의 부적절한 성행동이동현, 김경미pp. 9-14노인과 운전장성만pp. 15-19주요우울증에서 아드레날린 알파 2 수용체 유전자 다형성과 Mirtazapine 치료반응의 연관성에 대한 연관연구김수연, 최홍, 임신원, 김진우, 명우재, 송지혜, 정재원, 이유진, 김도관pp. 20-26치매 선별용 간이정신상태검사(Mini-Mental State Examination for Dementia Screening；MMSE-DS)와 단축형 MMSE-DS(SMMSE-DS)의 한국 노인 정상규준 연구김태희, 김기웅, 추일한, 윤종철, 유승호, 주진형, 박준혁, 김정란, 김문두, 문석우, 이석범, 도연자, 이동우, 한지원pp. 27-37
원문 보기