Abstract: Background As China's population ages，there is a growing concern about the prevalence of polypharmacy among the elderly and the phenomenon of potential irrational drug use among this demographic. Objective Toinvestigate the potential inappropriate medication（PIM）and potential prescription omission in the community elderly patients by three different evaluation criteria，and to provide evidence for regulating the management of drug therapy for the elderly. Methods From April 2021 to June 2021，this study adopted the method of cluster sampling to select Wuhan，Yichang，Qianjiang and Zhijiang in Hubei Province as sample areas. A total of 12 communities in 3 streets or towns were randomly selected from each as research units. Elderly patients in the communities who met the pre-established inclusion and exclusion criteria were selected as the research subjects. Comprehensively applying the Beers criteria（2023 edition），the Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment（STOPP/START）criteria（2014 edition），and the Chinese Criteria for Potentially Inappropriate Medication Use in Elderly People（2017 edition），the PIM and potential prescription omissions of elderly patients in the communities of Hubei Province were analyzed. Results A total of 1，011 elderly patients in the community were included，among whom 420 were male patients（43.08%）and 591 were female patients（57.92%）. The comparison of the number of medication types among patients of different genders，ages and types of chronic diseases showed statistically significant differences（P<0.05）. PIM was detected in 294 cases（29.08%）of patients using the Beers criteria（2023 edition）. Using the STOPP/START criteria（2014 edition），PIM was detected in 189 patients（18.69%），and a total of 229 cases of prescription omission occurred. According to the Chinese criteria for PIM use in elderly people（2017 edition），PIM was detected in 296 cases（29.28%）of patients. The drug with the highest frequency of PIM detected by Beers criteria（2023 edition）was fast-release nifedipine. The drug with the highest frequency of PIM was non-steroidal anti-inflammatory drugs according to STOPP/START criteria（2014 edition），and the item with the highest frequency of prescription omission was type 2 diabetes without metformin treatment. The drug with the highest PIM frequency detected by Chinese criteria for PIM use in elderly people（2017 edition）was nifedipine. Conclusion The problems of PIM and prescription omission in the course of treatment of community elderly patients should be paid attention to，and it is necessary to strengthen the drug therapy management of community elderly patients. The three criteria each other to a certain extent，enabling a more comprehensive screening of PIM and prescription omission issues.

Key words: Precision medicine, Medication review, Community elderly patients, Potentially inappropriate medication, Beers criteria, STOPP/START criteria, Chinese Criteria for Potentially Inappropriate Medication Use in Elderly People, Hubei province

摘要： 背景 随着我国人口老龄化形势日趋严峻，老年人多重用药现象愈发严重，老年群体中潜在不合理用药现象普遍存在。目的 以3种不同的评价标准探讨社区老年患者潜在不适当用药（PIM）和潜在处方遗漏情况，为规范老年人药物治疗管理提供依据。方法 于2021年4月—2021年6月，本研究采用整群抽样的方法选择湖北省武汉市、宜昌市、潜江市和枝江市作为样本地区，随机各抽取3个街道或乡镇的共12个社区作为调研单位，选取符合预先制定的纳入排除标准的社区老年患者作为研究对象，综合运用Beers标准（2023年版）、老年人不适当处方筛查工具/处方遗漏筛查工具（STOPP/START）标准（2014年版）和中国老年人PIM标准（2017年版），分析湖北省社区老年患者的PIM和潜在处方遗漏情况。结果 共纳入社区老年患者1011例，其中男性患者有420例（43.08%），女性患者591例（57.92%）。不同性别、年龄和慢性病种类患者的服药种数比较，差异有统计学意义（P<0.05）。采用Beers标准（2023年版）检出294例（29.08%）患者存在PIM；采用STOPP/START标准（2014年版）检出189例（18.69%）患者存在PIM，共发生处方遗漏229例次；采用中国老年人PIM标准（2017年版）检出296例（29.28%）患者存在PIM。采用Beers标准（2023年版）检测出PIM频率最高的药物为速释硝苯地平；采用STOPP/START标准（2014年版）筛查出PIM频率最高的药物为非甾体抗炎药，处方遗漏频率最高的条目是2型糖尿病未接受二甲双胍治疗；采用中国老年人PIM标准（2017年版）检测出PIM频率最高的药物为硝苯地平。结论 社区老年患者治疗过程中存在的PIM和处方遗漏问题应引起重视，需要加强对社区老年患者的药物治疗管理。三种标准在一定程度上能够互相补充，可以更全面地筛选出PIM以及处方遗漏问题。

关键词: 精准医学, 用药审查, 社区老年患者, 潜在不适当用药, Beers 标准, 老年人不适当处方筛查工具/处方遗漏筛查工具标准, 中国老年人潜在不适当用药标准, 湖北省