medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2022-25-12-18medalphabet-2852Research ArticleСтатьиАнализ лекарственных назначений пациентов с фибрилляцией предсердий в сочетании с хронической болезнью почек на соответствие критериям STOPP/STARTAnalysis of drug prescriptions of patients with atrial fibrillation in combination with chronic kidney disease for compliance with STOPP/START criteriahttps://orcid.org/0000-0001-6823-6077ШаталоваН. А.ShatalovaN. A.

Шаталова Наталья Андреевна, ассистент, кафедра терапии и полиморбидной патологии имени академика М.С. Вовси

Москва

Shatalova Natalya A., assistant of Therapy and Polymorbid Pathology named after Academician M. S. Vovsi Dept

Moskow 

natalia.sh2018@gmail.comhttps://orcid.org/0000-0003-1316-7654БатюкинаС. В.BatyukinaS. V.

Батюкина Светлана Владимировна, аспирант 3-го года, кафедра терапии и полиморбидной патологии имени академика М.С. Вовси

Москва

Batyukina Svetlana V., 3st year postgraduate student of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi Dept

Moskow 

batyukina.svetlana@yandex.ruhttps://orcid.org/0000-0003-3091-7904ЧерняеваМ. С.ChernyaevaM. S.

Черняева Марина Сергеевна, кандидат медицинских наук, доцент, врач-гериатр, терапевт

Москва

Chernyaeva Marina S., PhD Med, associate professor, geriatrician, general practitioner

Moskow

doctor@cherniaeva.ruhttps://orcid.org/0000-0001-5801-3742КочетковА. И.KochetkovA. I.

Кочетков Алексей Иванович, кандидат медицинских наук, доцент кафедры терапии и полиморбидной патологии имени академика М.С. Вовси

Москва

eLibrary SPIN: 9212–6010

Kochetkov Alexey I., PhD Med, associate professor of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi Dept

Moskow

eLibrary SPIN: 9212–6010

ak_info@list.ruhttps://orcid.org/0000-0001-6573-4169ЭбзееваЕ. Ю.EbzeevaYe. Yu.

Эбзеева Елизавета Юрьевна, кандидат медицинских наук, доцент кафедры терапии и полиморбидной патологии имени академика М.С. Вовси

Москва

eLibrary SPIN: 2011–6362

Ebzeeva Elizaveta Yu., PhD Med, associate professor of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi Dept

Moskow

eLibrary SPIN: 2011–6362

https://orcid.org/0000-0002-0795-8225ОстроумоваО. Д.OstroumovaO. D.

Остроумова Ольга Дмитриевна, профессор, доктор медицинских наук, заведующая кафедрой терапии и полиморбидной патологии имени академика М.С. Вовси

Москва

eLibrarySPIN: 3910–6585

Ostroumova Olga D., DM Sci (habil.), professor, head of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi Dept

Moskow

eLibrary. SPIN: 3910–6585

ostroumova.olga@mail.ruФедеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской ФедерацииРоссияRussian Medical Academy of Continuous Professional EducationRussian FederationГБУЗ «Госпиталь для ветеранов войн № 2 ДЗМ»РоссияHospital for War Veterans № 2Russian FederationФедеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации; Федеральное государственное автономное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава Российской Федерации (Сеченовский университетРоссияRussian Medical Academy of Continuous Professional Education; Research Institute of Molecular and Personalized Medicine, Russian Medical Academy of Continuous Professional EducationRussian Federation202225112022025Современная поликлиника (2)1218Copyright © Шаталова Н.А., Батюкина С.В., Черняева М.С., Кочетков А.И., Эбзеева Е.Ю., Остроумова О.Д., 20222022Шаталова Н.А., Батюкина С.В., Черняева М.С., Кочетков А.И., Эбзеева Е.Ю., Остроумова О.Д.Shatalova N.A., Batyukina S.V., Chernyaeva M.S., Kochetkov A.I., Ebzeeva Y.Y., Ostroumova O.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/2852Актуальность

Актуальность. С каждым годом растет процент пациентов пожилого и старческого возраста. Среди данной когорты пациентов фибрилляция предсердий (ФП) является одним из самых часто встречаемых нарушений ритма. При этом ФП многократно усиливает риск возникновения тромбоэмболических осложнений. Течение ФП у пациентов пожилого возраста часто осложнено хронической болезнью почек (ХБП). При ведении пациентов данной группы мы часто сталкиваемся с полипрагмазией, которая влияет на качество жизни пациента, повышает риск падений, потенциально уменьшает продолжительность жизни. С целью оптимизации фармакотерапии были разработаны критерии STOPP/START

Цель исследования

Цель исследования. Анализ лекарственных назначений у пациентов старше 65 лет с ФП и ХБП на предмет соответствия критериям STOPP/START.

Материалы и методы

Материалы и методы. Было проанализировано 339 историй болезни кардиологического отделения и 180 историй болезни пациентов многопрофильного стационара. В каждом отделении пациенты были разделены на 2 группы: пациенты с ФП в сочетании с ХБП С3а и пациенты с ФП в сочетании с ХБП С3б и С4.

Результаты

Результаты. В терапевтическом отделении 96,1 % первой группы и 100,0 % второй группы больных не были назначены ЛС, которые рекомендованы пожилым пациентам (START-критерии). У 64,7 % пациентов из первой группы и у 53,8 % пациентов второй в листах назначений присутствуют потенциально не рекомендованные, но назначенные ЛС (STOPP-критерии) В кардиологическом отделении процент пациентов, у которых отсутствовали в медикаментозной терапии рекомендованные ЛС, в 3-й группе 92%, в 4-й группе 97%. Процент пациентов, которым были назначены потенциально не рекомендованные препараты, в 3-й группе 45%, в 4-й группе 48%.

Вывод

Вывод. У большинства пациентов пожилого и старческого возраста с ФП в сочетании с ХБП имеются как START-, так и STOPP-критерии, что требует тщательного анализа назначенной медикаментозной терапии.

The percentage of elderly and senile patients is growing every year. Among this cohort of patients, atrial fibrillation (AF) is one of the most common rhythm disorders. At the same time, AF repeatedly increases the risk of thromboembolic complications. The course of AF in elderly patients is often complicated by chronic kidney disease (CKD). When managing patients of this group, we often encounter polypragmasia, which affects the patient’s quality of life, increases the risk of falls, and potentially reduces life expectancy. In order to optimize pharmacotherapy, STOPP/ START criteria were developed.

The purpose of the study was the analysis of drug prescriptions in patients over 65 years of age with AF and CKD for compliance with the STOPP/ START criteria.

Material and methods

Material and methods. 339 case histories of the cardiology department and 180 case histories of patients of the therapeutic department of the Veterans of Wars multidisciplinary hospital were analyzed. In each department, patients were divided into 2 groups: patients with AF in combination with CKD C3a and patients with AF in combination with CKD C3b and C4.

Results

Results. In the therapeutic department, 96.1% of the first group and 100.0% of the second group of patients were not prescribed drugs that are recommended for elderly patients (START criteria). 64.7% of patients from the first group and 53.8% of patients from the second group have potentially not recommended, but prescribed drugs (STOPP criteria) in the appointment lists In the cardiology department, the percentage of patients who did not have the recommended drugs (START criteria) in drug therapy was 92% in group 3, 97% in group 4. The percentage of patients who were prescribed potentially non-recommended drugs (STOP criteria) in group 3 45%, in group 4 48%.

Conclusion

Conclusion. Most elderly and senile patients with AF in combination with CKD have both START and STOPP criteria, which dictates a thorough analysis of the prescribed drug therapy.

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The authors declare that there are no conflicts of interest present.