46 KB162 KB40 KB200220262011Kos, MitjaNerat, Tomažštevilka:1letnik:50str. 34-44ISSN:0351-0026COBISSID:2944369URN:URN:NBN:SI:doc-C7VI9AEKslInštitut za varovanje zdravja Republike SlovenijeZdravstveno varstvodrugmerilapredpisovanje zdravilstarostnikizdravilaAnaliza neprimernega predpisovanja zdravil starostnikom v Sloveniji na podlagi Beersovih in Larochevih meril| Analysis of inappropriate medication prescribing in Slovenian elderly patients based on the Beers and Laroche criteria|Purpose: Given a great number of elderly people using medications, the main objective of the analysis was to determine the prevalence of prescribing inappropriate medications to the elderly in 2006. Potentially inappropriate medications were identified on the basis of the Beers 2002 and the Laroche 2007 criteria and according to the combined criteria of inappropriate prescribing. Methods: We analysed the anonymous database of dispensed outpatient medications prescribed in 2006 provided by The Health Insurance Institute of Slovenia. Beersćs 2002 criteria were used for the elderly people aged 65 or more and the Laroche 2007 and the combined criteria for the age group of 75 years and over. Results: According to the Beers 2002 criteria, 22.41 per cent of the elderly patients were prescribed at least one inappropriate medical ingredient; by the Laroche 2007 criteria, the percentageof older people receiving inappropriate drugs was 25.72 and by the combined criteria 35.95. Judging by the published data, these shares are rather high. The prevalence of inappropriately prescribed medications (with respect to all prescriptions) was 3.43 per cent by the Beers 2002 criteria, 4.01 per cent, according to the Laroche 2007 criteria and 6.03 per cent according to the combined criteria. These shares are higher than in Croatia mainly because of the greater quantity of inappropriate medications used in Slovenia. Further it was discovered, that the probability of being prescribed an inappropriate medication increases along with the number of prescribed medications. Discussion: Despite the established high prevalence of potentially inappropriate prescriptions, there is no unanimity in the literature concerning the influence of inappropriate prescribing on the healthof older people. We would emphasise here that the criteria discussed areintended to help rather than convince physicians to choose the appropriate therapy. They are also meant to be used in pharmacoepidemiological studies. Ways to reduce the rate of inappropriate medication prescribing are put forwardNamen: Zaradi velikega števila starostnikov, ki jemljejo zdravila, je bil cilj analize ugotoviti razširjenost neprimernega predpisovanja zdravil v letu 2006 med starostniki v Sloveniji. Za analizo neprimernega predpisovanja smo izbrali merila Beers 2002 in merila Laroche 2007 in Skupna merila neprimernega predpisovanja. Metode: Analiza je bila opravljena na anonimizirani zbirki podatkov Zavoda za zdravstveno zavarovanje Slovenije o izdaji ambulantno predpisanih zdravil v letu 2006. Analizo z merili Beers 2002 smo opravili na vzorcu starostnikov, starih 65 let in več, analizo z merili Laroche 2007 in s Skupnimi merili pa na vzorcu starostnikov, starih 75 let in več. Rezultati: Po merilih Beers 2002 je 22,41 % starostnikov prejelo vsaj eno neprimerno učinkovino, po merilih Laroche 2007 25,72 %, po Skupnih merilih pa 35,95 %. Glede na objavljene raziskave so deleži dokaj visoki. Delež receptov z neprimerno predpisanimi zdravili (glede na vse recepte) je v primeru analize z merili Beers 2002 zna{al 3,43 %, v primeru z merili Laroche 2007 4,01 % in na podlagi Skupnih meril 6,03 %. Deleži so višji kot na Hrvaškem, predvsem zaradi večjega števila zdravil, ki jih uporabljamo v Sloveniji. Ugotovili smo tudi, da se verjetnost, da bolnik prejme neprimerno zdravilo, povečuje se s številom predpisanih zdravil. Zaključek: Kljub ugotovljenemu dokaj visokemu deležu neprimernega predpisovanja so mnenja v objavljeni literaturi glede vpliva na zdravstveno stanje starostnikov deljena.Pomembno je poudariti, da naj bi merila bila pomoč zdravnikom pri izbiri zdravljenja in ne kot zapoved. Prav tako so namenjeni uporabi v farmakoloških in epidemioloških študijah. Predlagani so načini, kako zmanjšati delež neprimernega predpisovanja zdravilTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaInštitut za varovanje zdravja RS