Hovstadius Bo, Hovstadius Karl, Astrand Bengt, Petersson Göran
eHealth Institute, Linnaeus University, Kalmar, Sweden.
BMC Clin Pharmacol. 2010 Dec 2;10:16. doi: 10.1186/1472-6904-10-16.
An increase in the use of drugs and polypharmacy have been displayed over time in spite of the fact that polypharmacy represents a well known risk factor as regards patients' health due to the adverse drug reactions, drug-drug interactions, and low adherence to drug therapy arising from polypharmacy. For policymakers, as well as for clinicians, it is important to follow the developing trends in drug use and polypharmacy over time. We wanted to study if the prevalence of polypharmacy in an entire national population has changed during a 4-year period.
By applying individual-based data on dispensed drugs, we have studied all dispensed prescribed drugs for the entire Swedish population during four 3-month periods 2005-2008. Five or more (DP ≥5) and ten or more (DP ≥10) dispensed drugs during the 3-month period was applied as the cut-offs indicating the existence of polypharmacy and excessive polypharmacy respectively.
During the period 2005-2008, the prevalence of polypharmacy (DP≥5) increased by 8.2% (from 0.102 to 0.111), and the prevalence of excessive polypharmacy (DP≥10) increased by 15.7% (from 0.021 to 0.024).In terms of age groups, the prevalence of polypharmacy and excessive polypharmacy increased as regards all ages with the exception of the age group 0-9 years. However, the prevalence of excessive polypharmacy displayed a clear age trend, with the largest increase for the groups 70 years and above. Furthermore, the increase in the prevalence of polypharmacy was, generally, approximately twice as high for men as for women. Finally, the mean number of dispensed drugs per individual increased by 3.6% (from 3.3 to 3.4) during the study period.
The prevalence of polypharmacy and excessive polypharmacy, as well as the mean number of dispensed drugs per individual, increased year-by-year in Sweden 2005-2008.
尽管多重用药因药物不良反应、药物相互作用以及多重用药导致的药物治疗依从性低等问题,是一个众所周知的影响患者健康的风险因素,但随着时间的推移,药物使用和多重用药的情况仍在增加。对于政策制定者和临床医生而言,跟踪药物使用和多重用药随时间的发展趋势非常重要。我们想研究在四年时间里,全国总人口中多重用药的患病率是否发生了变化。
通过应用基于个体的配药数据,我们研究了2005年至2008年期间四个为期3个月的时间段内,瑞典全体人口的所有配给处方药。以三个月内五种或更多(DP≥5)和十种或更多(DP≥10)配药作为分别表明存在多重用药和过度多重用药的临界值。
在2005年至2008年期间,多重用药(DP≥5)的患病率增加了8.2%(从0.102增至0.111),过度多重用药(DP≥10)的患病率增加了15.7%(从0.021增至0.024)。就年龄组而言,除了0至9岁年龄组外,所有年龄段的多重用药和过度多重用药患病率均有所增加。然而,过度多重用药的患病率呈现出明显的年龄趋势,70岁及以上年龄组的增幅最大。此外,总体而言,男性多重用药患病率的增幅约为女性的两倍。最后,在研究期间,人均配药数量增加了3.6%(从3.3增至3.4)。
2005年至2008年期间,瑞典多重用药和过度多重用药的患病率以及人均配药数量逐年增加。