낙상으로 입원한 노인환자의 입원 직전 약물복용 실태

Abstract

The purpose of this study was to investigate polypharmacy and potentially inappropriate medication use in elderly patients admitted to hospitals after falls. This is a retrospective survey study on 283 elderly patients aged 65 years or older admitted to a general hospital between January 1 and December 31, 2016. Data were collected using electronic medical records, and medications administered immediately prior to admission were examined. Potentially inappropriate medication use for elderly patient was investigated using the Beers criteria, and the data were analyzed by Chi-square test and t-test. The average age of the participants was 79.4±8.2, and the study population included 226 women (79.9%) and 57 men (20.1%). One or more chronic diseases were observed in 76.0% of the participants, and the average number of diseases was 1.4±1.1. The average number of self-administered medications per day was 4.9±3.7, and 55.1% took five or more medications. According to the Beers criteria, potentially inappropriate medication use was found in 163 patients (37.8%). The following medications were used: 25 cases of sulfonylureas for diabetes mellitus treatment; 24 cases of proton-pump inhibitors (which inhibits gastric acid secretion) and diazepam (long-acting benzodiazepine); 12 cases of amitriptyline (antidepressant); and 10 cases of dimenhydrinate (antihistamine). There was a significant difference in polypharmacy according to age, and polypharmacy and potentially inappropriate medication use frequencies were significantly high when the insurance type was medical aid. Patients who experienced falls prior to admission had a high frequency of potentially inappropriate medication use. The number of chronic diseases and the number of medications taken were significantly high in polypharmacy and potentially inappropriate medication use patients. Therefore, it is necessary to minimize polypharmacy and potentially inappropriate medication use, and establish a system for systematically evaluating and managing medication use in the elderly at levels of primary health care services, hospitals, and local communities to prevent falls in the elderly.