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[德国心血管疾病预防研究:使用具有潜在成瘾性药物的社会梯度。对选定适应症组的分析]

[The German Cardiovascular Disease Prevention Study: social gradient in use of drugs with a potentially addictive nature. An analysis of selected indications groups].

作者信息

Breckenkamp J, Laaser U

机构信息

Institut für Bevölkerungsforschung und Sozialpolitik (IBS), Universität Bielefeld.

出版信息

Med Klin (Munich). 1999 Jun 15;94(6):306-13. doi: 10.1007/BF03044889.

DOI:10.1007/BF03044889
PMID:10420722
Abstract

BACKGROUND

Not only prescription but also turnover of medicines are well established by documentary evidence. However, there is a lack of information regarding the usage of drugs in different social classes.

MATERIALS AND METHODS

Within the scope of the German Cardiovascular Prevention Study (GCP), a cross-sectional community-based multicenter intervention study, (t0 = 1984/5, t1 = 1988 und t2 = 1991/2) the usage of drugs was examined. Four groups of drugs with a potentially addictive character (analgesics, sedatives, sleeping drugs, psychotropics) were analyzed with regard to socioeconomic differences in consumption.

RESULTS

A gradient was found for all analyzed groups of drugs. The data analysis of the 3 pooled surveys (t0, t1, t2) regarding analgesics yields an OR of 1.67 (95%-CI: 1.41 to 1.98) for the middle class (mc) and 2.33 (95%-CI: 1.95 to 2.80) for the lower class (lc) (reference being the upper class). For psychotropics the values are OR = 1.40 (95%-CI: 1.12 to 1.75) (mc) and OR = 2.01 (95%-CI: 1.58 to 2.55) (lc), for sleeping drugs OR = 1.31 (95%-CI: 1.05 to 1.65) (mc) and OR = 1.54 (95%-CI: 1.37 to 1.96) (lc) and for sedatives OR = 1.40 (95%-CI: 1.19 to 1.64) (mc) and OR = 1.94 (95%-CI: 1.63 to 2.30) (lc).

CONCLUSION

Considering possible indicators of different drug utilization (age, sex, occupation, individual health, last medical care, mental distress) the gradient was diminished but--especially for the lower class--remained at significant OR's between 1.37 and 1.65.

摘要

背景

药物的处方情况和使用周转率都有充分的文献证据。然而,关于不同社会阶层药物使用情况的信息却很匮乏。

材料与方法

在德国心血管疾病预防研究(GCP)的范围内,这是一项基于社区的多中心横断面干预研究(t0 = 1984/5,t1 = 1988,t2 = 1991/2),对药物使用情况进行了检查。分析了四类具有潜在成瘾性的药物(镇痛药、镇静剂、安眠药、精神药物)在消费方面的社会经济差异。

结果

在所有分析的药物类别中都发现了一种梯度差异。对关于镇痛药的3次汇总调查(t0、t1、t2)进行数据分析,中产阶级(mc)的比值比(OR)为1.67(95%置信区间:1.41至1.98),下层阶级(lc)为2.33(95%置信区间:1.95至2.80)(以上层阶级为参照)。对于精神药物,相应的值为OR = 1.40(95%置信区间:1.12至1.75)(中产阶级)和OR = 2.01(95%置信区间:1.58至2.55)(下层阶级),对于安眠药,OR = 1.31(95%置信区间:1.05至1.65)(中产阶级)和OR = 1.54(95%置信区间:1.37至1.96)(下层阶级),对于镇静剂,OR = 1.40(95%置信区间:1.19至1.64)(中产阶级)和OR = 1.94(95%置信区间:1.63至2.30)(下层阶级)。

结论

考虑到不同药物使用的可能指标(年龄、性别、职业、个人健康状况、上次医疗护理、精神困扰),这种梯度差异有所减小,但——尤其是对于下层阶级——在1.37至1.65之间的显著比值比仍然存在。

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