Pizzuti Renato, Caffari Bruno, Binkin Nancy
Osservatorio della Regione Campania, Napoli Regione Campania OER.
Ig Sanita Pubbl. 2006 Jan-Feb;62(1):11-26.
To evaluate prescription drug use in the elderly and in particular, to determine the number and types of medications taken, whether and to what extent drugs that are contraindicated in this age group are being used, and what type of prescription check may be performed by primary care physicians.
A survey was performed in a sample of non-institutionalised elderly subjects (= 65 years). These were selected by cluster sampling in 11 of 20 Italian regions and were interviewed in the home by trained interviewers using a standardised questionnaire.
Eighty-seven percent of interviewed subjects reported that they had taken at least one medication in the previous year; higher frequencies were found in age groups= 75 years. The most common therapeutic classes of drugs used in all participating regions, in the previous week, were cardiovascular, gastrointestinal, metabolic (including drugs to treat diabetes) and nervous system. Among interviewed subjects, 45.3% reported using 4 or more different drugs, though wide regional differences were observed (Campania 60.5%, Bolzano 35.6%); 7.2 % were taking potentially inappropriate drugs while 2.3% were taking medications that may lead to potentially harmful interactions. In addition, 84.9% of subjects reported that their primary care physician regularly checked their drug prescriptions.
The high frequency of prescription drug use observed in the elderly is a diffuse phenomenon, related to the worsening health conditions that inevitably accompany aging. Considering the extent of this phenomenon, care should be taken to improve qualitative (i.e. contraindications in the elderly, potential drug-interactions) and quantitative (high number of medications taken by the elderly) appropriateness in physician prescribing. In addition, special attention must be placed on regularly checking drug therapies in the elderly.
评估老年人的处方药使用情况,特别是确定所服用药物的数量和种类,是否以及在何种程度上使用了该年龄组禁忌的药物,以及初级保健医生可能进行何种类型的处方检查。
对一组非机构化老年受试者(≥65岁)进行了一项调查。这些受试者通过整群抽样从意大利20个地区中的11个地区选取,并由经过培训的访谈员使用标准化问卷在其家中进行访谈。
87%的受访受试者报告称他们在前一年至少服用过一种药物;在年龄≥75岁的年龄组中发现频率更高。在所有参与地区,前一周使用的最常见治疗类药物为心血管、胃肠道、代谢(包括治疗糖尿病的药物)和神经系统药物。在受访受试者中,45.3%报告使用了4种或更多不同药物,不过各地区差异较大(坎帕尼亚为60.5%,博尔扎诺为35.6%);7.2%的人正在服用潜在不适当药物,而2.3%的人正在服用可能导致潜在有害相互作用的药物。此外,84.9%的受试者报告称他们的初级保健医生会定期检查他们的药物处方。
在老年人中观察到的高频率处方药使用是一种普遍现象,与衰老不可避免伴随的健康状况恶化有关。考虑到这一现象的程度,应注意提高医生处方在质量(即老年人的禁忌证、潜在药物相互作用)和数量(老年人服用的药物数量多)方面的适宜性。此外,必须特别关注定期检查老年人的药物治疗情况。