社区中独立生活的老年队列的自我报告药物副作用——墨尔本健康老龄化纵向研究（MELSHA）：患病率和危险因素的横断面分析。
Self-reported medication side effects in an older cohort living independently in the community--the Melbourne Longitudinal Study on Healthy Ageing (MELSHA): cross-sectional analysis of prevalence and risk factors.
机构信息
School of Primary Health Care, Monash University, Melbourne, Australia.
出版信息
BMC Geriatr. 2010 Jun 10;10:37. doi: 10.1186/1471-2318-10-37.
BACKGROUND
Medication side effects are an important cause of morbidity, mortality and costs in older people. The aim of our study was to examine prevalence and risk factors for self-reported medication side effects in an older cohort living independently in the community.
METHODS
The Melbourne Longitudinal Study on Healthy Ageing (MELSHA), collected information on those aged 65 years or older living independently in the community and commenced in 1994. Data on medication side effects was collected from the baseline cohort (n = 1000) in face-to-face baseline interviews in 1994 and analysed as cross-sectional data. Risk factors examined were: socio-demographics, health status and medical conditions; medication use and health service factors. Analysis included univariate logistic regression to estimate unadjusted risk and multivariate logistic regression analysis to assess confounding and estimate adjusted risk.
RESULTS
Self-reported medication side effects were reported by approximately 6.7% (67/1000) of the entire baseline MELSHA cohort, and by 8.5% (65/761) of those on medication. Identified risk factors were increased education level, co-morbidities and health service factors including recency of visiting the pharmacist, attending younger doctors, and their doctor's awareness of their medications. The greatest increase in risk for medication side effects was associated with liver problems and their doctor's awareness of their medications. Aging and gender were not risk factors.
CONCLUSION
Prevalence of self-reported medication side effects was comparable with that reported in adults attending General Practices in a primary care setting in Australia. The prevalence and identified risk factors provide further insight and opportunity to develop strategies to address the problem of medication side effects in older people living independently in the community setting.
背景
药物副作用是老年人发病率、死亡率和医疗费用增加的一个重要原因。我们的研究目的是调查在一个独立生活于社区的老年人群中，自我报告的药物副作用的患病率和相关危险因素。
方法
墨尔本老龄化纵向研究（MELSHA）收集了居住在社区中的 65 岁或以上的老年人的信息，并于 1994 年开始。药物副作用的数据来自基线队列（n=1000），在 1994 年的面对面基线访谈中进行了横断面数据分析。检查的危险因素包括：社会人口统计学、健康状况和医疗状况；药物使用和医疗服务因素。分析包括单变量逻辑回归来估计未调整的风险，以及多变量逻辑回归分析来评估混杂因素并估计调整后的风险。
结果
大约 6.7%（67/1000）的整个基线 MELSHA 队列和 8.5%（65/761）的用药者报告了自我报告的药物副作用。确定的危险因素包括教育程度较高、合并症和医疗服务因素，包括最近去看药剂师、看年轻医生以及医生对他们药物的了解。药物副作用风险最大的增加与肝脏问题和医生对他们药物的了解有关。年龄和性别不是危险因素。
结论
自我报告的药物副作用的患病率与在澳大利亚初级保健环境中接受全科医生治疗的成年人报告的患病率相当。患病率和确定的危险因素为在独立生活于社区的老年人中解决药物副作用问题提供了进一步的见解和机会。
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