Exploratory research for prescription of potentially inappropriate medications in elderly patients: a survey using 2015 Japanese Guidelines

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K15299
• Research Category: Grant-in-Aid for Challenging Exploratory Research
• Allocation Type: Multi-year Fund
• Research Field: Medical sociology
• Research Institution: University of Tsukuba
• Principal Investigator: Fujie Keiko 筑波大学, 医学医療系, 研究員 (80623959)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Keywords: 多剤処方 / 不適切処方 / ポリファーマシー / 高齢者 / 薬物療法 / 薬物有害事象 / 医療費 / 国民皆保険

Outline of Final Research Achievements

In recent years, rapid increase of elderly population has become a major social problem in advanced nations. They tend to be prescribed an increasing number of drugs due to having multiple illness, which might include inappropriate medications leading to health hazards and rising healthcare cost.This study aimed to evaluate the current status of potentially inappropriate medications prescribed for elderly outpatients using the recent Japanese Guidelines and to determine factors that are related to prescribing potentially inappropriate medications.
The results confirmed that polypharmacy is prevalent among elderly people, and that polypharmacy increased the risk of PIMs. It is recommended that proactive prescription screening using the Guidelines be conducted in cases in which the overall number of drugs exceeds five, or the number of chronic-phase systemic drugs exceeds four. The results also indicated that being prescribed by multiple physicians was related to PIMs.

Free Research Field

医療社会学

Academic Significance and Societal Importance of the Research Achievements

本研究より、総薬剤数5剤以上または慢性期全身作用薬剤数4剤以上の高齢患者はPIMsが処方されている可能性が高いため、積極的にリストを活用してスクリーニングを実施し、処方内容を精査することが推奨される。特に睡眠薬の処方は慎重に行うべきであると考えられる。
この結果が公表されることにより、外来高齢者の多剤処方に対する医師および薬局薬剤師の問題意識が高まり、処方見直しを行うことによって、薬剤有害事象による健康被害の減少や医療費の抑制につながることが期待される。