상급종합병원 근처의 한 지역약국 처방전 분석에 의한 노인 환자의 다약제복용과 약제비용 및 잠재적으로 부적절한 약물사용 관련 위험인자
Risk Factors of Potentially Inappropriate Medications and Cost by Polypharmacy among Elderly Patients of a Community Pharmacy near a Top Tier General Hospital
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective: Polypharmacy is one of the main causes of inappropriate medication use, adverse drug-related events and cost. It aimed to investigate the status of polypharmacy and potentially inappropriate medication (PIM), the factors affecting polypharmacy and cost in elderly outpatients. Method: A pharmacy claim data were retrospectively analyzed with elderly patients prescriptions at a pharmacy located near a top tier general hospital. The numbers of medications per person, prevalence of polypharmacy and PIM according to the 2012 Beers criteria and Korea PIM list, medication cost and the factors affecting polypharmacy were investigated. Results: Forty-six percentages of the elderly outpatients received polypharmacy and over 21% of them had medications listed in Beers or Korean PIM. In multiregressional analysis, we found that age, gender and insurance types were affective factors of polypharmacy. (p < 0.001, 0.047, 0.009, respectively). The cost of polypharmacy with PIM in elderly outpatients was increased with age. Various approaches of interventions would be further required.
Abstract
Objective: Polypharmacy is one of the main causes of inappropriate medication use, adverse drug-related events and cost. It aimed to investigate the status of polypharmacy and potentially inappropriate medication (PIM), the factors affecting polypharmacy and cost in elderly outpatients. Method: A pharmacy claim data were retrospectively analyzed with elderly patients prescriptions at a pharmacy located near a top tier general hospital. The numbers of medications per person, prevalence of polypharmacy and PIM according to the 2012 Beers criteria and Korea PIM list, medication cost and the factors affecting polypharmacy were investigated. Results: Forty-six percentages of the elderly outpatients received polypharmacy and over 21% of them had medications listed in Beers or Korean PIM. In multiregressional analysis, we found that age, gender and insurance types were affective factors of polypharmacy. (p < 0.001, 0.047, 0.009, respectively). The cost of polypharmacy with PIM in elderly outpatients was increased with age. Various approaches of interventions would be further required.
참고문헌 (18)
- "Elderly statistics 2012"[URL]
- Edwards IR., "Adverse drug reactions : definitions, diagnosis, and management", Lancet, 356(9237), pp.1255~1259 (2000)
- Goldberg RM., "Drug-drug and drug-disease interactions in the emergency department : analysis of a high-risk population", Am J Emerg Med, 14(5), pp.447~450 (1996)
- Ruggiero C., "Potentially inappropriate drug prescriptions and risk of hospitalization among older, Italian, nursing home residents : the ULISSE project", Drugs Aging, 27(9), pp.747~758 (2010)
- "American Geriatrics Society 2012 Beers Criteria Update Expert Panel, American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults", J Am Geriatr Soc, 60(4), pp.616~631 (2012)
- Zhan C., "Potentially inappropriate medication use in the community-dwelling elderly : findings from the 1996 Medical Expenditure Panel Survey", JAMA, 286(22), pp.2823~2829 (2001)
- McLeod PJ., "Defining inappropriate practices in prescribing for elderly people : a national consensus panel", CMAJ, 156(3), pp.385~391 (1997)
- Gallagher P., "STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment)", Int J Clin Pharmacol Ther, 46(2), pp.72~83 (2008)
- Holt S., "Potentially inappropriate medications in the elderly: The PRISCUS list", Dtsch Arztebl Int, 107(31- 32), pp.543~551 (2010)
- Winit-Watiana W., "Criteria for highrisk medication use in Thai older patients", Arch Gerontol Geriatr, 47(1), pp.35~51 (2008)
- Akazawa M., "Potentially inappropriate medication use in elderly Japanese patients", Am J Geriatr Pharmacother, 8(2), pp.146~160 (2010)
- Chang CB., "Potentially inappropriate medications in geriatric outpatients with polypharmacy : application of six sets of published explicit criteria", Br J Clin Pharmacol, 72(3), pp.482~489 (2011)
- Albert SM., "Potentially inappropriate medicaions and risk of hospitalization in retirees : analysis of a US retiree health claims database", Drugs Aging, 27(5), pp.407~415 (2010)
- O’Sullivan DP., "A prevalence study of potentially inappropriate prescribing in Irish longterm care residents", Drugs Aging, 30(1), pp.39~49 (2013)
- 이숙향, "Development of a List of Potentially Inappropriate Drugs for the Korean Elderly Using the Delphi Method", Healthcare Informatics Research, 16(4), pp.231~252 (2010), 대한의료정보학회
- Blozik E., "Polypharmacy and potentially inappropriate medication in the adult, community-dwelling population in Switzerland", Drugs Aging, 30(7), pp.561~568 (2013)
- Haider SI., "Trends in polypharmacy and potential drug-drug interactions across educational groups in elderly patients in Sweden for the period 1992-2002", Int J Clin Pharmacol Ther, 45(12), pp.643~653 (2007)
- Amann U., "Prescribing of potentially inappropriate medications for the elderly : an analysis based on the PRISCUS list", Dtsch Arztebl Int, 109(5), pp.69~75 (2012)