锦州市老年糖尿病及伴有合并症患者用药安全现状调查
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摘要
目的调查老年糖尿病及伴有合并症患者用药安全情况及其影响因素,为提高老年糖尿病及伴有合并症患者用药安全性及开展合理用药健康教育提供理论依据。方法于2017年2月至12月,应用便利抽样方法,使用研究者自行设计的量表对452位老年糖尿病及伴有合并症非住院老年人进行问卷调查。结果被调查的老年糖尿病患者中不安全服药行为有服错药、漏服药、自行停药、自行增减服药剂量、服用过期药等。卡方检验中老年糖尿病患者医疗费用报销比例能够影响老年人的用药安全,而Logistic回归分析显示用药安全的主要影响因素是:年龄、既往职业、文化程度、家庭人均月收入、服药时间、药品来源和是否接受过用药安全的健康教育(P<0. 05)。其中,既往职业、文化程度、家庭人均月收入与是否接受过健康教育是保护性因素;年龄、服药时间与药品来源是危险因素。结论糖尿病及伴有合并症老年人用药安全知识相对缺乏,同时这些老年人存在许多错误的认知和行为等常常导致老年糖尿病及伴有合并症患者不良反应和用药隐患的出现,这应该引起家属及老年人的重视。
Objective To investigate the drug safety and its influencing factors in elderly patients with diabetes mellitus and complications,and provide theoretical basis for improving drug safety and developing health education on rational use of drugs in the elderly patients with diabetes mellitus and complications. Methods 452 elderly patients with diabetes mellitus and complications were selected by convenient sampling and were investigated by using questionnaire of self-designed scale from February to December 2017.Results Among the elderly diabetic patients investigated,unsafe drug taking behaviors included taking wrong drugs,drug leakage,drug withdrawal,drug dosage increase or decrease,and taking expired drugs. Chi-square test showed that the proportion of medical expense reimbursement for middle-aged and elderly diabetes patients could affect the drug safety of the elderly,and Logistic regression analysis showed that the main influencing factors for drug safety were age,previous profession,educational level,family average monthly income,time of drug use,drug source and whether they had received health education on rational use of drugs( P< 0. 05).The past occupation,educational level,family monthly income and whether they have received health education are protective factors;age,medication time and drug source are risk factors. Conclusion The elderly patients with diabetes mellitus and the comorbidities relatively lack knowledge about drug safety. At the same time,these elderly with diabetes mellitus and comorbidities have certain wrong cognition and behaviors,which often lead to the occurrence of adverse reactions and drug risks in the elderly patients,which should be paid attention to by their families and the elderly themselves.
Objective To investigate the drug safety and its influencing factors in elderly patients with diabetes mellitus and complications,and provide theoretical basis for improving drug safety and developing health education on rational use of drugs in the elderly patients with diabetes mellitus and complications. Methods 452 elderly patients with diabetes mellitus and complications were selected by convenient sampling and were investigated by using questionnaire of self-designed scale from February to December 2017.Results Among the elderly diabetic patients investigated,unsafe drug taking behaviors included taking wrong drugs,drug leakage,drug withdrawal,drug dosage increase or decrease,and taking expired drugs. Chi-square test showed that the proportion of medical expense reimbursement for middle-aged and elderly diabetes patients could affect the drug safety of the elderly,and Logistic regression analysis showed that the main influencing factors for drug safety were age,previous profession,educational level,family average monthly income,time of drug use,drug source and whether they had received health education on rational use of drugs( P< 0. 05).The past occupation,educational level,family monthly income and whether they have received health education are protective factors;age,medication time and drug source are risk factors. Conclusion The elderly patients with diabetes mellitus and the comorbidities relatively lack knowledge about drug safety. At the same time,these elderly with diabetes mellitus and comorbidities have certain wrong cognition and behaviors,which often lead to the occurrence of adverse reactions and drug risks in the elderly patients,which should be paid attention to by their families and the elderly themselves.
引文
[1] Wuerzner G,Pruijm M,Maillard M,et al. Marked associationbetween obesity and glomerular hyperfiltration:a cross-sectionalstudy in an African population. Am J Kidney Dis, 2010, 56(2):303-312.
[2]蒋华,刘涛,陈文,等.社区老年人用药安全现状及对策研究[J].中国实用护理杂志,2011,27(28):64-65.
[3] Maurizio C,Francesca M,Andrea C,et al. A Review of Phar-macogenetics of Adverse Drug Reactions in Elderly People[J].Drug Safety,2012,35(1):3-20.
[4]赵慧楠,戴付敏,张希,等.社区居家和养老机构老年人用药安全影响因素及对策[J].中国实用护理杂志,2014,30(1):4-6.
[5] Weedle PB,Poston JM,Parish PA. Drug prescribing in resi-dential homes for elderly people in the United Kingdom[J].DICP,1990,24(5):533.
[6] Hallan SI,Matsushita K,Sang Y,et al. On behalf of the Chro-nic Kidney Disease Prognosis Consortium,Age and association ofkidney measures with mortality and end-stage renal disease[J].JAMA,2012,20(2):1-12.
[7] Conway B,Miller RG,Costacou T,et al. Temporal patterns inoverweight and obesity in type 1 diabetes[J]. Diabet Med,2010,27(12):398-404.
[8] Heerspink HJ,de Zeeuw D. The kidney in type 2 diabetes thera-py[J]. Rev Diabet Stud,2011,8(3):392-402.
[9] Ruggenenti P,Cravedi P,Remuzzi G. The RAAS in the patho-genesis and treatment of diabetic nephropathy[J]. Nat RevNephrol,2010,6(6):319-330.
[10] Opondo D,Eslami S,Visscher S,et a1. Inappropriateness ofmedication prescriptions to elderly patients in the primary caresetting:a systematic review[J]. PLOS ONE,2012,7(8):43617.
[11]高超,王淑君,于普林.人口老龄化的现状及发展趋势[J].中华老年医学杂志,2014,33(8):924-926.
[12] Cao Y,Li W,Yang G,et al. Diabetes and hypertension havebecome leading causes of CKD in Chinese elderly patients:acomparison between 1990-1991 and 2009-2010[J]. Int UrolNephrol,2012,44(4):1269-1276.
[13] Wolf G,Muller N,Mandecka A,et al. Association of diabeticretinopathy and renal function in patients with types 1 and 2 dia-betes mellitus[J]. Clin Nephrol,2007,68(2):81-86.
[14] Jim Jose. Promoting drug safety in elderly-Needs a proactive ap-proach[J]. Indian Journal of Medical Research,2012,136(12):362-364.
[15]许芸,谢晓华,阳世伟,等.护理不良事件回顾性分析及对策[J].中国实用护理杂志,2013,29(10):58-60.
[16] Dwyer JP,Parving HH,Hunsicker LG,et al. Renal dysfunc-tion in the presence of normoal buminuria in type 2 diabetes:results from the DEMAND Study[J]. Cardiorenal Med,2012,2(1):1-10.
[17] Couchoud C,Villar E. End-stage renal disease epidemic in di-abetics:is there light at the end of the tunnel[J]. Nephrol Di-al Transplant,2013,28(5):1073-1076.
[18]贾丽娜,庄海林,陈越,等.居家老年慢性病患者生活质量及影响因素分析[J].中华老年医学杂志,2013,32(12):1361-1364.
[2]蒋华,刘涛,陈文,等.社区老年人用药安全现状及对策研究[J].中国实用护理杂志,2011,27(28):64-65.
[3] Maurizio C,Francesca M,Andrea C,et al. A Review of Phar-macogenetics of Adverse Drug Reactions in Elderly People[J].Drug Safety,2012,35(1):3-20.
[4]赵慧楠,戴付敏,张希,等.社区居家和养老机构老年人用药安全影响因素及对策[J].中国实用护理杂志,2014,30(1):4-6.
[5] Weedle PB,Poston JM,Parish PA. Drug prescribing in resi-dential homes for elderly people in the United Kingdom[J].DICP,1990,24(5):533.
[6] Hallan SI,Matsushita K,Sang Y,et al. On behalf of the Chro-nic Kidney Disease Prognosis Consortium,Age and association ofkidney measures with mortality and end-stage renal disease[J].JAMA,2012,20(2):1-12.
[7] Conway B,Miller RG,Costacou T,et al. Temporal patterns inoverweight and obesity in type 1 diabetes[J]. Diabet Med,2010,27(12):398-404.
[8] Heerspink HJ,de Zeeuw D. The kidney in type 2 diabetes thera-py[J]. Rev Diabet Stud,2011,8(3):392-402.
[9] Ruggenenti P,Cravedi P,Remuzzi G. The RAAS in the patho-genesis and treatment of diabetic nephropathy[J]. Nat RevNephrol,2010,6(6):319-330.
[10] Opondo D,Eslami S,Visscher S,et a1. Inappropriateness ofmedication prescriptions to elderly patients in the primary caresetting:a systematic review[J]. PLOS ONE,2012,7(8):43617.
[11]高超,王淑君,于普林.人口老龄化的现状及发展趋势[J].中华老年医学杂志,2014,33(8):924-926.
[12] Cao Y,Li W,Yang G,et al. Diabetes and hypertension havebecome leading causes of CKD in Chinese elderly patients:acomparison between 1990-1991 and 2009-2010[J]. Int UrolNephrol,2012,44(4):1269-1276.
[13] Wolf G,Muller N,Mandecka A,et al. Association of diabeticretinopathy and renal function in patients with types 1 and 2 dia-betes mellitus[J]. Clin Nephrol,2007,68(2):81-86.
[14] Jim Jose. Promoting drug safety in elderly-Needs a proactive ap-proach[J]. Indian Journal of Medical Research,2012,136(12):362-364.
[15]许芸,谢晓华,阳世伟,等.护理不良事件回顾性分析及对策[J].中国实用护理杂志,2013,29(10):58-60.
[16] Dwyer JP,Parving HH,Hunsicker LG,et al. Renal dysfunc-tion in the presence of normoal buminuria in type 2 diabetes:results from the DEMAND Study[J]. Cardiorenal Med,2012,2(1):1-10.
[17] Couchoud C,Villar E. End-stage renal disease epidemic in di-abetics:is there light at the end of the tunnel[J]. Nephrol Di-al Transplant,2013,28(5):1073-1076.
[18]贾丽娜,庄海林,陈越,等.居家老年慢性病患者生活质量及影响因素分析[J].中华老年医学杂志,2013,32(12):1361-1364.
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