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多药治疗对加拿大老年人健康的影响。

The impact of polypharmacy on the health of Canadian seniors.

机构信息

Canadian Institute for Health Information, Toronto, ON, Canada.

出版信息

Fam Pract. 2012 Aug;29(4):427-32. doi: 10.1093/fampra/cmr124. Epub 2012 Jan 5.

DOI:10.1093/fampra/cmr124
PMID:22223743
Abstract

BACKGROUND

Prescription medication use increases with age. Seniors face an increased risk of adverse drug reactions from medications, partly because the kidneys and liver can lose functional ability with increasing age, resulting in the need for changes in dosage.

OBJECTIVE

To use population survey data to understand the extent and impact of multiple medication use and adverse drug events among Canadian seniors.

METHODS

This study consists of analysis of data from the Canadian Survey of Experiences with Primary Health Care, which was conducted through telephone by Statistics Canada in 2008. These analyses focussed on the 3132 respondents who were ≥ 65 years of age.

RESULTS

Twenty-seven per cent of seniors reported taking five or more medications on a regular basis. Within the past year, 12% of seniors taking five or more medications experienced a side effect that required medical attention compared with 5% of seniors taking only one or two medications. Even when controlling for age and number of chronic conditions, the number of prescription medications was associated with the rate of emergency department use. Less than half of all seniors reported having received medication reviews and having the possible side effects of their prescription medications explained to them by their physician.

CONCLUSIONS

Many Canadian seniors have an elevated risk of adverse events due to taking a high number of prescription medications and not having the potential side effects and drug interactions explained to them. There are interventions that can potentially reduce polypharmacy and adverse events, including routine medication reviews.

摘要

背景

随着年龄的增长,处方药的使用量也会增加。老年人因药物而产生不良反应的风险增加,部分原因是肾脏和肝脏的功能会随着年龄的增长而下降,这导致需要调整剂量。

目的

利用人口调查数据了解加拿大老年人中多种药物使用和药物不良反应的程度和影响。

方法

本研究基于加拿大初级医疗保健体验调查的数据进行分析,该调查由加拿大统计局于 2008 年通过电话进行。这些分析集中在 3132 名年龄在 65 岁及以上的受访者。

结果

27%的老年人定期服用五种或五种以上的药物。在过去一年中,服用五种或五种以上药物的老年人中有 12%出现了需要医疗关注的副作用,而服用一种或两种药物的老年人中这一比例为 5%。即使控制了年龄和慢性疾病的数量,处方药的数量也与急诊室使用的比率有关。不到一半的老年人报告说他们接受了药物审查,医生向他们解释了他们处方药物的潜在副作用和药物相互作用。

结论

许多加拿大老年人因服用大量处方药且未被告知潜在副作用和药物相互作用而面临更高的不良反应风险。有一些干预措施可以潜在地减少多种药物治疗和不良反应,包括常规药物审查。

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