Volume 22 Issue 1
Jan.  2024
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HUANG Qian, XU Xin, SHAO Jie, ZHANG Fang, ZHU Min, ZHOU Lulu, ZHANG Shengbing, HUANG Jiaoling, LIU Wei. Analysis of potential irrational drug use and training needs of family doctors in the diagnosis and treatment of patients with multiple chronic diseases[J]. Chinese Journal of General Practice, 2024, 22(1): 93-96. doi: 10.16766/j.cnki.issn.1674-4152.003339
Citation: HUANG Qian, XU Xin, SHAO Jie, ZHANG Fang, ZHU Min, ZHOU Lulu, ZHANG Shengbing, HUANG Jiaoling, LIU Wei. Analysis of potential irrational drug use and training needs of family doctors in the diagnosis and treatment of patients with multiple chronic diseases[J]. Chinese Journal of General Practice, 2024, 22(1): 93-96. doi: 10.16766/j.cnki.issn.1674-4152.003339

Analysis of potential irrational drug use and training needs of family doctors in the diagnosis and treatment of patients with multiple chronic diseases

doi: 10.16766/j.cnki.issn.1674-4152.003339
Funds:

 PWRd2021-08

 PKJ2019-Y48

 沪卫人事[2022]65号

  • Received Date: 2023-01-09
    Available Online: 2024-03-09
  •   Objective  To investigate the potential irrational drug use among community general practitioners in patients with multimorbidity diseases, and explore improvement strategies.  Methods  Twenty-one field research questionnaires of community potentially inappropriate medications (PIM) project were tested in the previous study of this project group. A total of 1 500 prescriptions were collected from 236 general practitioners on duty at 47 community health service centers from December 2021 to January 2022 in Pudong New Area, Shanghai using mechanical sampling method, and an online questionnaire survey was conducted.  Results  The 21 items with the highest frequency of PIM were "Digoxin for heart failure patients with normal ventricular systolic function", "ankle edema dependent on clinical manifestations of non-heart failure treated with loop Diuretic", etc. The difference analysis was made on the subjective frequency of PIM items, the subjective rationality judgment of general practitioners, and the actual objective frequency in prescriptions. The rank sum test suggested that there was a statistically significant difference between the subjective rationality judgment and objective occurrence frequency of 21 potentially irrational drug use items (P < 0.05); Compared with the subjective frequency judgment and subjective rationality judgment of 21 potential irrational drug use items, there was no significant difference between the two items except for the item "Nifedipine regular release dosage form as antihypertensive drug" (P > 0.05), and the other items had significant differences (P < 0.01); Linear regression analysis was conducted using the daily occurrence frequency of 21 PIMs as the dependent variable and 5 factors such as professional title and education as independent variables. The results showed that each factor had no significant impact on the daily occurrence frequency of PIMs (P > 0.05).  Conclusion  Currently, family doctors lack subjective understanding of the potential irrational use of medication in patients with multiple chronic diseases, and it is relatively common. Therefore, unified training and guidance should be carried out.

     

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  • [1]
    刘葳, 于德华, 金花, 等. 社区老年多病共存患者多重用药情况评价研究[J]. 中国全科医学, 2020, 23(13): 1592-1598. doi: 10.12114/j.issn.1007-9572.2020.00.026

    LIU W, YU D H, JIN H, et al. Analysis and Evaluation of Multiple Drug Use among Elderly Patients with Multiple Chronic Conditions in Community[J]. Chinese General Practice, 2020, 23(13): 1592-1598. doi: 10.12114/j.issn.1007-9572.2020.00.026
    [2]
    唐天娇, 曹立, 董碧蓉, 等. 老年人多病共存名词和定义专家共识(2022)[J]. 中华老年医学杂志, 2022, 41(9): 1028-1031. doi: 10.3760/cma.j.issn.0254-9026.2022.09.002

    TANG T J, CAO L, DONG B R, et al. Chinese expert consensus on the term and definition of multimorbidity in older adults(2022)[J]. Chinese Journal of Geriatrics, 2022, 41(9): 1028-1031. doi: 10.3760/cma.j.issn.0254-9026.2022.09.002
    [3]
    苏甦, 高灵灵, 马文瑶, 等. 门诊老年患者潜在不适当用药对全因住院时长和住院药品费用的影响[J]. 中国医院药学杂志, 2022, 42(14): 1488-1493. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYZ202214018.htm

    SU S, GAO L L, MA W Y, et al. Influence of potential inappropriate drug use on all-cause hospitalization duration and inpatient drug cost in elderly outpatients[J]. Chinese Journal of Hospital Pharmacy, 2022, 42(14): 1488-1493. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYZ202214018.htm
    [4]
    毛润越, 徐志杰, 方力争. 社区老年患者潜在不合理用药影响因素的思考[J]. 中国全科医学, 2020, 23(34): 4405-4406. doi: 10.12114/j.issn.1007-9572.2020.00.526

    MAO R Y, XU Z J, FANG L Z. Thoughts about associated factors of potential inappropriate medications among geriatric patients in primary care[J]. Chinese General Practice, 2020, 23(34): 4405-4406. doi: 10.12114/j.issn.1007-9572.2020.00.526
    [5]
    杜林娜, 刘珊, 郭艳, 等. 老年人潜在不恰当用药与衰弱危险因素之间的相关性及研究进展[J]. 中华全科医学, 2022, 20(1): 104-108. doi: 10.16766/j.cnki.issn.1674-4152.002288

    DU L N, LIU S, GUO Y, et al. Association and research progress between potentially inappropriate medication and the risk factors of frailty in the elderly[J]. Chinese Journal of General Practice, 2022, 20(1): 104-108. doi: 10.16766/j.cnki.issn.1674-4152.002288
    [6]
    李晨, 陈孟莉. Beers标准和STOPP/START标准对老年住院患者潜在不适当用药的评价[J]. 解放军医学院学报, 2019, 40(3): 201-206. doi: 10.3969/j.issn.2095-5227.2019.03.001

    LI C, CHEN M L. Evaluation of potential inappropriate medication in hospitalized elderly patients based on Beers and STOPP/START criteria[J]. Academic Journal of Chinese PLA Medical School, 2019, 40(3): 201-206. doi: 10.3969/j.issn.2095-5227.2019.03.001
    [7]
    沈剑. 上海某社区60岁以上人群中中心性肥胖与多种慢性疾病的关系[J]. 中国保健营养, 2019, 29(28): 136-137.

    SHEN J. The relationship between central obesity and multiple chronic diseases among people over 60 years old in a community in Shanghai[J]. China Health Care & Nutrition, 2019, 29(28): 136-137.
    [8]
    柏丁兮, 高静, 杨直, 等. 老年慢病共存患者治疗负担量表的研制[J]. 中国全科医学, 2023, 26(13): 1613-1620. doi: 10.12114/j.issn.1007-9572.2022.0763

    BAI D X, GAO J, YANG Z, et al. Development of a Treatment Burden Scale for Elderly Patients with Coexisting Chronic Diseases[J]. Chinese General Practice, 2023, 26(13): 1613-1620. doi: 10.12114/j.issn.1007-9572.2022.0763
    [9]
    方力争, 徐志杰. 《澳大利亚与新西兰老年医学会立场声明: 老年人处方》解读[J]. 中国全科医学, 2019, 22(7): 747-752. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX201907004.htm

    FANG L Z, XU Z J. Interpretation of Australian and New Zealand Society for Geriatric Medicine Position Statement of Prescribing in Older People[J]. Chinese General Practice, 2019, 22(7): 747-752. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX201907004.htm
    [10]
    VANIDA A, MANABU S, AIKO C, et al. Applying the Lists of Risk Drugs for Thai Elderly (LRDTE) as a mechanism to account for patient age and medicine severity in assessing potentially inappropriate medication use. [J]. RSAP, 2018, 14(5): 451-458.
    [11]
    徐志杰, 毛润越, 潘健将, 等. 我国社区卫生服务中心门诊处方的现状分析和改进策略[J]. 中国全科医学, 2019, 22(10): 1147-1152. doi: 10.12114/j.issn.1007-9572.2019.00.091

    XU Z J, MAO R Y, PAN J J, et al. Status Analysis and Improvement Strategies of Outpatient Prescriptions in Community Health Centers in China[J]. Chinese General Practice, 2019, 22(10): 1147-1152. doi: 10.12114/j.issn.1007-9572.2019.00.091
    [12]
    贾博颖, 周双, 周颖, 等. 基于STOPPFrail标准的衰弱老年患者潜在不合理用药的横断面研究[J]. 中国临床药理学与治疗学, 2020, 25(8): 916-925. https://www.cnki.com.cn/Article/CJFDTOTAL-YLZL202008012.htm

    JIA B Y, ZHOU S, ZHOU Y, et al. Potential inappropriate medications use in the geriatric condition of frail-ty based on STOPPFrail criteria: A cross-sectional study[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2020, 25(8): 916-925. https://www.cnki.com.cn/Article/CJFDTOTAL-YLZL202008012.htm
    [13]
    李为, 郭敏, 刘秀兰, 等. 116例不合理用药相关医疗损害案例分析[J]. 中国药师, 2022, 25(3): 490-493. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYSG202203022.htm

    LI W, GUO M, LIU X L, et al. Analysis of 116 Cases of Medical Damage Related to Irrational Drug Use[J]. China Pharmacist, 2022, 25(3): 490-493. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYSG202203022.htm
    [14]
    余芳, 郑艳玲, 董天一, 等. 家庭医生护理服务的老年人用药指导方式研究[J]. 中国社会医学杂志, 2021, 38(4): 451-454. https://www.cnki.com.cn/Article/CJFDTOTAL-GWSY202104022.htm

    YU F, ZHENG Y L, DONG T Y, et al. Study on the Guidance Mode of Drug Use for the Elderly in Healthcare Service Delivery of Family Doctors[J]. Chinese Journal of Social Medicine, 2021, 38(4): 451-454. https://www.cnki.com.cn/Article/CJFDTOTAL-GWSY202104022.htm
    [15]
    黄小舟, 黄际薇, 徐乐加, 等. 社区卫生服务中心药学服务工作实践与探索[J]. 中国药业, 2022, 31(8): 124-127. https://www.cnki.com.cn/Article/CJFDTOTAL-YYGZ202208032.htm

    HUANG X Z, HUANG J W, XU J L, et al. Exploration and Practice of Pharmaceutical Care in Community Health Service Center[J]. China Pharmaceuticals, 2022, 31(8): 124-127. https://www.cnki.com.cn/Article/CJFDTOTAL-YYGZ202208032.htm
    [16]
    陈子豪, 田野, 傅孟元, 等. 北京市东城区2014—2016年社区门诊不合理处方分析[J]. 中国医院管理, 2018, 38(12): 74-76. https://www.cnki.com.cn/Article/CJFDTOTAL-YYGL201812033.htm

    CHEN Z H, TIAN Y, FU M Y, et al. Analysis of Irrational Prescriptions in Community Outpatient in Dongcheng District, Beijing City from 2014 to 2016[J]. Chinese Hospital Management, 2018, 38(12): 74-76. https://www.cnki.com.cn/Article/CJFDTOTAL-YYGL201812033.htm
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