Kitzman Patrick, Cecil Darrin, Kolpek Jimmi Hatton
a Department of Rehabilitation Sciences , University of Kentucky, College of Health Sciences , Lexington , KY , USA.
b College of Pharmacy and College of Medicine , University of Kentucky , Lexington , KY , USA.
J Spinal Cord Med. 2017 Mar;40(2):147-153. doi: 10.1179/2045772314Y.0000000235. Epub 2016 Mar 9.
The purpose of this study was to examine the overall prevalence of polypharmacy within the spinal cord injury (SCI) population, the level of polypharmacy with respect to seven classes of high-risk drugs commonly used to treat secondary conditions in the SCI population, and the overall risks for drug-related problems (DRP) related to polypharmacy.
A retrospective case-control design.
A commercially available claims dataset that included patient cases from 4800 hospitals in the USA between 2007 and 2009.
Individuals with tetraplegia, paraplegia, and those with SCI but not specified as either tetraplegia or paraplegia as well as a control population of randomly selected, age- and sex-matched individuals without a diagnosis of SCI.
The overall prevalence of polypharmacy, the prevalence of commonly prescribed high-risk medications, and the prevalence of reported DRPs.
Overall, the patients in the SCI population were prescribed significantly more medications than their control counterparts. There was a higher rate of individuals being prescribed medications from multiple high-risk classes (e.g. analgesic-narcotics, anticonvulsant, antidepressant, and skeletal muscle relaxer), as well as multiple medications within each class (e.g. multiple analgesic-narcotics). The SCI group had a higher incidence of DRPs.
Our results are some of the first to demonstrate the extent of polypharmacy in individuals with SCI, including commonly prescribed high-risk medications, leading to a higher rate of DPRs. The higher rate of polypharmacy and DRPs can impact rehabilitation goals and community integration following neurologic injury.
本研究旨在调查脊髓损伤（SCI）人群中多重用药的总体患病率、针对常用于治疗SCI人群继发性疾病的七类高风险药物的多重用药水平，以及与多重用药相关的药物相关问题（DRP）的总体风险。
回顾性病例对照设计。
一个可商购的索赔数据集，其中包括2007年至2009年期间美国4800家医院的患者病例。
四肢瘫痪者、截瘫者、患有SCI但未明确为四肢瘫痪或截瘫者，以及随机选择的、年龄和性别匹配且未诊断为SCI的对照人群。
多重用药的总体患病率、常用高风险药物的患病率以及报告的DRP的患病率。
总体而言，SCI人群中的患者所开药物明显多于其对照对象。从多个高风险类别（如镇痛性麻醉药、抗惊厥药、抗抑郁药和骨骼肌松弛剂）开具药物的个体比例更高，并且每个类别内开具多种药物（如多种镇痛性麻醉药）的比例也更高。SCI组的DRP发生率更高。
我们的结果首次表明了SCI患者中多重用药的程度，包括常用的高风险药物，这导致了更高的DPR发生率。多重用药和DRP的较高发生率可能会影响神经损伤后的康复目标和社区融入。
