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10 年来法国东部老年人潜在不适当药物使用的趋势。

Trends of the potentially inappropriate medication consumption over 10 years in older adults in the East of France.

机构信息

Centre technique d'appui et de formation des Centres d'examens de santé (CETAF), 67-69 Avenue de Rochetaillée, Saint-Etienne cedex 02.

出版信息

Pharmacoepidemiol Drug Saf. 2009 Dec;18(12):1125-33. doi: 10.1002/pds.1762.

Abstract

PURPOSE

To describe the trends of potentially inappropriate medication (PIM) use in older adults from 1995 to 2004 in the East of France, by using the 1997 Beers criteria and its French update, and to assess risk factors for this PIM use.

METHODS

We carried out a repeated cross-sectional study using data collected among people aged >/=65 years, examined in the Center for Preventive Medicine. Studied variables were socio-demographic, clinical data, medication consumption and the self-health status. Joinpoint regression analysis was used to estimate the temporal changes in PIM rate.

RESULTS

30 683 participants were included. 51.2% were women. The mean age was 70.1 +/- 4.3 years [65-99]. The annual overall rate of PIM use decreased significantly during the study period. These rates range from 14.9% in 1995 to 9.0% in 2004 according the Beers criteria (-3.4% per year) and from 33.5% in 1995 to 19.3% in 2004 according to the French update criteria (-3.6% per year). The annual rate of medication users increased during the same period (+0.75% per year). The risk of PIM consumption increased with age, number of drugs and frequency of the visits to the physician (OR = 1.26 [1.18-1.35]). This risk was also higher among women (OR = 1.29 [1.18-1.40]), elderly living alone (OR = 1.09 [1.02-1.17]) and with those with low education level (OR = 1.19 [1.02-1.38]).

CONCLUSION

This study shows a decrease in PIM consumption. Despite an increase of drug use in the elderly, an improving of the quality of this consumption remains possible.

摘要

目的

使用 1997 年 Beers 标准及其法国更新版,描述 1995 年至 2004 年法国东部地区老年人中潜在不适当药物(PIM)使用的趋势,并评估这种 PIM 使用的危险因素。

方法

我们进行了一项重复的横断面研究,使用在预防医学中心检查的年龄大于等于 65 岁的人群中收集的数据。研究变量包括社会人口统计学、临床数据、药物使用和自我健康状况。使用 Joinpoint 回归分析估计 PIM 率的时间变化。

结果

共纳入 30683 名参与者。女性占 51.2%。平均年龄为 70.1 +/- 4.3 岁[65-99]。研究期间,总体 PIM 使用率呈显著下降趋势。根据 Beers 标准,这些比率从 1995 年的 14.9%降至 2004 年的 9.0%(每年下降 3.4%);根据法国更新标准,这些比率从 1995 年的 33.5%降至 2004 年的 19.3%(每年下降 3.6%)。同期药物使用者的数量也在增加(每年增加 0.75%)。PIM 消费的风险随着年龄、药物数量和医生就诊频率的增加而增加(OR=1.26[1.18-1.35])。女性(OR=1.29[1.18-1.40])、独居的老年人(OR=1.09[1.02-1.17])和受教育程度较低的老年人(OR=1.19[1.02-1.38])的风险更高。

结论

本研究显示 PIM 消费减少。尽管老年人的药物使用增加,但仍有可能提高这种药物使用的质量。

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