Medical Review Board of the Statutory Health Insurance Funds Mecklenburg-Vorpommern, Schwerin, Germany.
Pharmacoepidemiol Drug Saf. 2009 Dec;18(12):1206-13. doi: 10.1002/pds.1841.
To ascertain the rate and range of continuous polypharmacy in German general practices and compare practice characteristics and prescribing profiles in practices with a high rate of polypharmacy patients (HPP) and a low rate of polypharmacy patients (LPP), respectively.
This observational study used a database composed of prescription data from a large German statutory health insurance. We defined polypharmacy as the continuous prescription of five or more drugs and calculated the percentage of polypharmacy patients for each practice to identify HPP and LPP.
A total of 136 521 patients in 730 general practices received continuous medication. About 10% of these patients (14 293/136 521) received five or more different drugs. HPP had, on average, 15.1% polypharmacy patients compared to 4.2% in LPP. The total number of patients attending either a HPP or LPP was comparable (437 vs. 416; p = 0.102), but HPP had a higher number of patients with prescriptions (76.9% vs. 70.8%; p < 0.0001). The patients' age distribution was similar (68.0 in LPP vs. 68.8 in HPP) and there were slightly more female patients in LPP. Doctors in HPP prescribed proton pump inhibitors and NSAIDs more frequently than doctors in LPP, but there was no difference in the prescription of me-too drugs.
The absolute differences in age and gender distribution between HPP and LPP were modest. Prescribing quality, as measured by the rate of me-too drug prescriptions, was similar across all practices. Therefore, differences in the rate of polypharmacy in general practice cannot sufficiently be explained by these factors.
确定德国全科医生中持续多种药物治疗的比率和范围，并比较高多种药物治疗患者（HPP）和低多种药物治疗患者（LPP）比例的实践特征和处方特征。
本观察性研究使用了一个由德国一家大型法定健康保险公司的处方数据组成的数据库。我们将多种药物治疗定义为连续开五种或更多种药物，并计算每个实践中多种药物治疗患者的百分比，以确定 HPP 和 LPP。
730 家全科诊所的 136521 名患者接受了连续药物治疗。这些患者中约有 10%（14293/136521）接受了五种或更多种不同的药物。HPP 的多种药物治疗患者平均比例为 15.1%，而 LPP 为 4.2%。接受 HPP 或 LPP 治疗的患者总数相当（437 例比 416 例；p=0.102），但 HPP 的处方患者数量更多（76.9%比 70.8%；p<0.0001）。患者的年龄分布相似（LPP 为 68.0，HPP 为 68.8），LPP 中有略多的女性患者。HPP 中的医生比 LPP 中的医生更频繁地开质子泵抑制剂和 NSAIDs，但在开 me-too 药物方面没有差异。
HPP 和 LPP 之间的年龄和性别分布的绝对差异不大。处方质量，以 me-too 药物处方率衡量，在所有实践中相似。因此，全科医生中多种药物治疗的比率不能仅通过这些因素来解释。
