Fonseca T, Clara J G
Serviço de Medicina II, Hospital Pulido Valente, Lisboa.
Rev Port Cardiol. 2000 Sep;19(9):855-72.
Elderly patients are major consumers of prescription and nonprescription medications and the proper use of these agents can lead to more cost-effective strategies in reaching optimal health. The use of medications for the treatment of multiple co-morbid conditions in a single patient increases the risks of polypharmacy and non-compliance and raises the burden on the health care system and society.
To analyse the extent and nature of total and anti hypertensive, polypharmacy the most prevalent groups of drugs, the compliance rate and the costs related to polypharmacy in the hypertensive elderly.
A descriptive cross-sectional study was made of sixty-nine patients 65 years of age or older on follow-up for arterial hypertension at a central hospital in Lisbon. The study protocol consisted of a questionnaire performed by the physician. We calculated the monthly amount of individual prescription expense, after cost reduction from social insurance.
The patients used an average of 4.4 prescribed medications with a corresponding average of 6.4 pills per day. Drug use was greater in women than men. Hypertensive therapy involved a mean of 2 drugs. Antiplatelet drugs, coronary vasodilators, bezodiazepines, glucose regulators and hypolipidemic agents were the other major groups of drugs. Non-compliance was identified in only 14% of the patients. The average of individual prescription expenses was 5,076 Portuguese escudos (PTE) per month, of which 2,226 PTE was the average cost of antihypertensive agents.
With this study we were able to show the extent of poly-pharmacotherapy in a population of hypertensive elderly patients. We found a high rate of compliance, although the costs were frequently high.
老年患者是处方药和非处方药的主要消费群体，合理使用这些药物可带来更具成本效益的策略，以实现最佳健康状态。在单一患者中使用药物治疗多种合并症会增加多重用药和不依从的风险，并增加医疗保健系统和社会的负担。
分析老年高血压患者中总体和抗高血压多重用药的程度和性质、最常见的药物类别、依从率以及与多重用药相关的费用。
对里斯本一家中心医院65岁及以上接受动脉高血压随访的69名患者进行了描述性横断面研究。研究方案包括由医生填写的问卷。我们计算了扣除社会保险费用后的每月个人处方费用。
患者平均使用4.4种处方药，相应地平均每天服用6.4片药。女性的药物使用量高于男性。高血压治疗平均涉及2种药物。抗血小板药物、冠状动脉血管扩张剂、苯二氮䓬类药物、血糖调节剂和降血脂药物是其他主要药物类别。仅14%的患者被发现存在不依从情况。个人处方费用平均为每月5076葡萄牙埃斯库多（PTE），其中抗高血压药物的平均费用为2226 PTE。
通过这项研究，我们能够展示老年高血压患者群体中多药治疗的程度。我们发现依从率很高，尽管费用通常较高。
