Haider Syed Imran, Ansari Zahid, Vaughan Loretta, Matters Helen, Emerson Eric
Health Intelligence Unit, Victorian Government Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Res Dev Disabil. 2014 Nov;35(11):3071-80. doi: 10.1016/j.ridd.2014.07.060. Epub 2014 Aug 15.
Although polypharmacy is a medication safety concern leading to increased risk of non-adherence, adverse drug reaction and drug-drug interactions, polypharmacy and associated risk factors has rarely been investigated involving people with ID at a population level. The purpose of this paper is to analyze the prevalence of polypharmacy and to evaluate the role of different factors associated with polypharmacy in a state-wide representative population of adults with ID. In a population-based survey in Victoria, Australia, 897 people with ID 18 years of age or older were selected by simple random sampling. The data were collected from proxy respondents on behalf of people with ID. Polypharmacy was defined as the concomitant use of five or more medications. The data were weighted to reflect the age/sex/geographic distribution of the population. Results revealed that more than 76% of adults with ID had used prescribed medicine and about 21% were exposed to polypharmacy in the last two weeks. In both univariate and multivariate analyses, polypharmacy was significantly associated with older age, unemployment and inability to get help from family and friends if needed. After controlling for age, sex and severity of intellectual disability, polypharmacy was associated with having a blood pressure, blood cholesterol and blood glucose level check. Polypharmacy was also associated with a greater number of visits to general practitioners, fair or poor reported health status and inability to walk unaided. Subjects with epilepsy, diabetes, stroke, osteoporosis and cancer had a higher probability of polypharmacy. None of the disease inducing behaviors was associated with polypharmacy. This study highlights the need that medication should be regularly reviewed overall in ID population and particularly when polypharmacy exists.
尽管多重用药是一个药物安全问题，会导致不依从、药物不良反应和药物相互作用风险增加，但在人群层面，针对智力残疾者的多重用药及其相关风险因素很少被研究。本文旨在分析多重用药的患病率，并评估在全州具有代表性的成年智力残疾人群中，与多重用药相关的不同因素所起的作用。在澳大利亚维多利亚州开展的一项基于人群的调查中，通过简单随机抽样选取了897名18岁及以上的智力残疾者。数据由代理受访者代表智力残疾者收集。多重用药被定义为同时使用五种或更多药物。对数据进行加权以反映人群的年龄/性别/地理分布。结果显示，超过76%的成年智力残疾者使用过处方药，在过去两周内约21%的人存在多重用药情况。在单变量和多变量分析中，多重用药均与年龄较大、失业以及在需要时无法从家人和朋友处获得帮助显著相关。在控制了年龄、性别和智力残疾严重程度后，多重用药与进行血压、血液胆固醇和血糖水平检查有关。多重用药还与更多次就诊于全科医生、报告的健康状况为一般或较差以及无法独立行走有关。患有癫痫、糖尿病、中风、骨质疏松症和癌症的受试者多重用药的可能性更高。没有任何疾病诱发行为与多重用药相关。这项研究强调了在智力残疾人群中，尤其是存在多重用药情况时，应定期全面审查用药的必要性。
