关键词: 健康管理, 老年人, 慢性病, 入睡和睡眠障碍, 催眠药和镇静药

Abstract: Background  Inappropriate use of psychotropic drugs，especially sedatives and hypnotics，can increase the risk of falls in older people.Objective  To examine the use of sedative and hypnotic drugs in elderly chronic disease patients receiving standardized community-based management.Methods  By use of systematic sampling，we selected 581 cases as the participants from 60-80-year-old chronic disease patients receiving standardized community-based management from January to March in 2018 from Yuetan Community，Xicheng District，Beijing，including 512 of hypertension，277 of diabetes，50 of stroke and 190 of coronary heart disease.By consulting the electronic medical record system in 2017，we collected the data concerning sedative and hypnotic drugs use in the participants.Results  Of the participants，33.2%（193 cases） with a definite diagnosis of insomnia used sedative and hypnotic drugs.And the use rate of such drugs increased with age and number of chronic diseases（P<0.05）．Participants with 2 chronic diseases had higher use rate of sedative and hypnotic drugs than those with only 1（P<0.05）．The most frequently used three drugs were estazolam（63.2%，122/193），zolpidem （18.7%，36/193），and zopiclone（15.5%，30/193）．Most of the participants〔95.9%（185/193）〕 used a normal dose，only 4.1%（8/193）used an increased dose.31.6%（61/193）needed to use such drugs intermittently for at least 6 months each year，and 68.4%（132/193） used for 1-2 months.Conclusion  The use rate of sedative and hypnotic drugs in elderly chronic disease patients is high，and it increases with age and the number of chronic diseases，but the long-term use rate is not high.In view of this，we should pay attention to the medication status of those at a very advanced age or with multiple chronic diseases，and give them medication guidance，to reduce the occurrence of falls and other adverse health events

Key words: Health management, Aged, Chronic disease, Sleep initiation and maintenance disorders, Hypnotics and sedatives