在一组因失禁而寻求治疗的老年患者队列中，普遍开具的可能导致尿症状的药物的流行率。
Prevalence of commonly prescribed medications potentially contributing to urinary symptoms in a cohort of older patients seeking care for incontinence.
出版信息
BMC Geriatr. 2013 Jun 10;13:57. doi: 10.1186/1471-2318-13-57.
BACKGROUND
Several medication classes may contribute to urinary symptoms in older adults. The purpose of this study was to determine the prevalence of use of these medications in a clinical cohort of incontinent patients.
METHODS
A cross-sectional study was conducted among 390 new patients aged 60 years and older seeking care for incontinence in specialized outpatient geriatric incontinence clinics in Quebec, Canada. The use of oral estrogens, alpha-blocking agents, benzodiazepines, antidepressants, antipsychotics, ACE inhibitors, loop diuretics, NSAIDs, narcotics and calcium channel blockers was recorded from each patient's medication profile. Lower urinary tract symptoms and the severity of incontinence were measured using standardized questionnaires including the International Consultation on Incontinence Questionnaire. The type of incontinence was determined clinically by a physician specialized in incontinence. Co-morbidities were ascertained by self-report. Logistic regression analyses were used to detect factors associated with medication use, as well as relationships between specific medication classes and the type and severity of urinary symptoms.
RESULTS
The prevalence of medications potentially contributing to lower urinary tract symptoms was 60.5%. Calcium channel blockers (21.8%), benzodiazepines (17.4%), other centrally active agents (16.4%), ACE inhibitors (14.4%) and estrogens (12.8%) were most frequently consumed. Only polypharmacy (OR = 4.9, 95% CI = 3.1-7.9), was associated with medication use contributing to incontinence in analyses adjusted for age, sex, and multimorbidity. No associations were detected between specific medication classes and the type or severity of urinary symptoms in this cohort.
CONCLUSION
The prevalence of use of medications potentially causing urinary symptoms is high among incontinent older adults. More research is needed to determine whether de-prescribing these medications results in improved urinary symptoms.
背景
几种药物类别可能会导致老年患者出现尿路症状。本研究旨在确定在有失禁症状的临床患者队列中，这些药物的使用情况。
方法
在加拿大魁北克的专门老年失禁门诊中，对 390 名年龄在 60 岁及以上、因失禁寻求治疗的新患者进行了一项横断面研究。从每位患者的用药记录中记录了口服雌激素、α-受体阻滞剂、苯二氮䓬类、抗抑郁药、抗精神病药、血管紧张素转换酶抑制剂、噻嗪类利尿剂、非甾体抗炎药、阿片类药物和钙通道阻滞剂的使用情况。使用国际尿失禁咨询问卷对下尿路症状和失禁严重程度进行了测量。通过一名专门治疗失禁的医生对失禁类型进行临床确定。通过自我报告确定合并症。使用逻辑回归分析来检测与药物使用相关的因素，以及特定药物类别与尿路症状类型和严重程度之间的关系。
结果
有潜在下尿路症状的药物的患病率为 60.5%。钙通道阻滞剂（21.8%）、苯二氮䓬类（17.4%）、其他中枢活性药物（16.4%）、血管紧张素转换酶抑制剂（14.4%）和雌激素（12.8%）的使用率最高。只有多药治疗（OR=4.9，95%CI=3.1-7.9）与调整年龄、性别和合并症后分析中的药物使用与失禁有关。在该队列中，未发现特定药物类别与尿路症状的类型或严重程度之间存在关联。
结论
有潜在尿路症状的药物在有失禁症状的老年患者中使用率很高。需要进一步研究以确定是否减少这些药物的使用是否会改善尿路症状。
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