中国老年患者门诊潜在不适当用药现状及影响因素的Meta分析

目的 系统评价中国老年患者门诊潜在不适当用药（potentially inappropriate medication,PIM）现状及影响因素,为降低老年患者门诊用药风险提供理论依据。方法 使用计算机以主题词和自由词相搭配的方式检索PubMed、Web of Science、Cochrane Library、Embase、中国知网、万方数据和维普数据库中与中国老年患者门诊PIM发生率及影响因素有关的研究,检索时限为2000年1月至2023年8月,文献筛选、资料提取和质量评价由2~3人完成,使用Stata 16.0进行Meta分析。结果 本研究共纳入37篇相关文献,总处方量为1 153 750张,PIM总发生219 538张,文献质量评分最高9分,最低5分,无低质量文献。Meta分析结果显示,中国老年患者门诊PIM总发生率为23.2%。年龄（OR=1.21,95%CI：1.16~1.27）、失眠（OR=3.47,95%CI：1.43~8.41）、合并冠心病（OR=1.86,95%CI：1.43~2.35）、合并疾病数量（OR=1.37,95%CI：1.24~1.52）、用药数量（OR=1.95,95%CI：1.59~2.38）、医生职称（OR=1.29,95%CI：1.23~1.36）均是中国老年患者门诊PIM发生的影响因素。结论 中国老年患者门诊PIM发生率差异较大,年龄、合并冠心病、合并疾病数量、用药数量和医生职称均是PIM发生的促进因素。

Current status and influencing factors of potentially inappropriate medication in elderly outpatients in China: A Meta-analysis

Objective To systematically review the current status and influencing factors of potentially inappropriate medication (PIM) in elderly outpatients in China, and to provide a theoretical basis for reducing the risk of medication in elderly outpatients. Methods PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang and VIP databases were searched by matching subject words and free words for studies on the status and influencing factors of PIM in elderly outpatients in China. The retrieval time was from January 2000 to August 2023. Two to three people completed the literature screening, data extraction and quality evaluation process. Stata 16.0 was used for Meta-analysis. Results A total of 37 literatures were included in this study. The total number of prescriptions was 1 153 750, and the total number of PIM was 219 538. The highest quality score of literature was 9 points, and the lowest was 5 points, and no low-quality literature was found. The results of Meta-analysis showed that the incidence of PIM in elderly outpatients in China was 23.2%. Age (OR=1.21, 95%CI: 1.16-1.27), insomnia (OR=3.47, 95%CI: 1.43-8.41), merging coronary heart disease (OR=1.86, 95%CI: 1.43-2.35), merging disease number (OR=1.37, 95%CI: 1.24-1.52), number of medications (OR=1.95, 95%CI: 1.59-2.38), physician’s professional title (OR=1.29, 95%CI: 1.23-1.36) were the influence factors of elderly patients with outpatient PIM happened in China. Conclusion The incidence of PIM in elderly outpatients in China is different. Age, merging coronary heart disease, merging disease number, number of medications and physician’s professional title are the promoting factors of PIM.