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국내 노인 파킨슨병 환자에서의 잠재적으로 부적절한 약물사용 현황에 대한 연구
서미경 ( Mi Kyung Seo ),배민경 ( Min Kyung Bae ),이인향 ( Iyn Hyang Lee ),전성실 ( Seongsill Jeon ),윤정현 ( Jeong Hyun Yoon ) 영남대학교 약품개발연구소 2016 영남대학교 약품개발연구소 연구업적집 Vol.26 No.-
Objectives: The presenl study assessed the prevalence of the potentially inappropriate medication (PIM) use in Korean elderly patients with Parkinson``s disease. In addition, this study examined risk factors that affect PIM use. Method: A retrospective, observational study was conducted using Korean National Health Insurance claims database of 2009. PIM use in Parkinson``s disease patients aged 65 years or older was examined based on 2012 Beers Criteria. Multivariable logistic regression was conducted to identify risk factors for PIM use. Results: Among 5,277 elderly patients with Parkinson``s disease, 88.9% of patients used PIM(s) at least once. The average number of PIM items used per patient was 4.2. PIM use ratio, the proporfion of total amount of PIMs to all medications per patient, was 12.6%. Frequently used PIM therapeutic classes were benzodiazepines (32,7%), first-generation antihistamines (19.2%), and prokinetics (17.5%). Individual PIMs most commonly used included chlorpheniramine (11,4%), levosulpiride (10.9%), diazepam (9.0%), and alprazolam (7.6%). Women (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.11-1.16), medical aid (OR 1.18, 95% CI 1.15-1.21), and long-term facilities (OR 2,43, 95% CI 2.22-2.65) were shown to be risk factors associated with PIM use. Of particular, wide variation in PIM use was associated with the types of healthcare facility. Conclusion: The PIM prevalence was very high in elderly Parkinson``s disease patients. Nationally effective and systematic efforts to identify and prevent PIM use should be made to ensure patient safety and to improve quality of care in the elderly.
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