Yang Ming, Lu Jing, Hao Qiukui, Luo Li, Dong Birong
The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China.
Department of Pharmacy, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China.
Arch Gerontol Geriatr. 2015 Mar-Apr;60(2):328-33. doi: 10.1016/j.archger.2014.11.004. Epub 2014 Nov 25.
The aim of this study is to explore the differences among older adults who are rural or urban residents with respects to their socioeconomic position, chronic health conditions and medication use. This cross-sectional study included 887 community-dwelling older adults (≥60 years) from western China. Trained interviewers collected data from all of the study subjects through face-to-face interviews. Polypharmacy was defined as the concomitant use of five or more medications. A total of 717 participants were included in the study analyses. Compared with their urban counterparts, the older adults in rural China were more likely to have more chronic health conditions, and a lower education level, annual income and insurance coverage rate. In addition, the rural inhabitants were less likely to use medications (58.7% vs. 75.7%, p<0.001). The intensity of medication use (the mean number of drugs) was 1.7 for rural residents and 2.3 for urban residents (p<0.001). The prevalence of polypharmacy was significantly lower in rural residents than urban residents (11.5% vs. 17.5%, p=0.021). Urban residence (odds ratios (OR) 1.89, 95% confidence intervals (CI) 1.03-3.48), number of chronic conditions (OR 1.95, 95% CI 1.16-3.30), diabetes (OR 4.14, 95% CI 2.33-7.37), and cardiovascular disease (CVD) (OR 2.09, 95% CI 1.25-3.51) were positively associated with polypharmacy, whereas good self-rated health (OR 0.32, 95% CI 0.16-0.65) was negatively associated with polypharmacy. In conclusion, urban residence is independently associated with polypharmacy in Chinese elders regardless of chronic health conditions and socioeconomic status.
本研究旨在探讨城乡老年居民在社会经济地位、慢性健康状况和用药情况方面的差异。这项横断面研究纳入了来自中国西部的887名社区居住的老年人（≥60岁）。经过培训的访谈员通过面对面访谈收集了所有研究对象的数据。多重用药被定义为同时使用五种或更多种药物。共有717名参与者纳入研究分析。与城市老年居民相比，中国农村老年居民更有可能患有更多慢性健康问题，且教育水平、年收入和保险覆盖率较低。此外，农村居民用药的可能性较小（58.7%对75.7%，p<0.001）。农村居民的用药强度（药物平均数量）为1.7，城市居民为2.3（p<0.001）。农村居民多重用药的患病率显著低于城市居民（11.5%对17.5%，p=0.021）。城市居住（比值比（OR）1.89，95%置信区间（CI）1.03 - 3.48）、慢性病数量（OR 1.95，95% CI 1.16 - 3.30）、糖尿病（OR 4.14，95% CI 2.33 - 7.37）和心血管疾病（CVD）（OR 2.09，95% CI 1.25 - 3.51）与多重用药呈正相关，而自我健康评价良好（OR 0.32，95% CI 0.16 - 0.65）与多重用药呈负相关。总之，在中国老年人中，无论慢性健康状况和社会经济地位如何，城市居住与多重用药独立相关。
