Nishtala P S, Soo L
School of Pharmacy, University of Otago, Dunedin, New Zealand.
Intern Med J. 2015 Jun;45(6):624-9. doi: 10.1111/imj.12757.
The prescriptions for proton pump inhibitors (PPI) to treat acid-related disorders continue to rise internationally and in New Zealand. Concerns have been raised regarding its widespread use, costs and potential adverse effects in older people.
This study aimed to characterise the utilisation of PPI by older people (aged 65 years and older) in New Zealand from 2005 to 2013.
Repeated cross-sectional analysis of population-level dispensing data was conducted from 1 January 2005 to 31 December 2013. Dispensing data for all PPI prescriptions from 2005 to 2013 were obtained from the Ministry of Health, New Zealand. Utilisation was measured in defined daily doses (DDD) per 1000 older people per day using the World Health Organization Collaborating Centre for Drug Statistics Methodology anatomic, therapeutic and chemical classification system. Utilisation was standardised by sex, age, ethnicity and district health board.
Overall PPI utilisation showed a 26.7% increase from 2005 to 2013, from 273.41 to 346.53 DDD/1000/day. The greatest utilisation was observed in individuals aged between 80 and 84 years. Middle Eastern/Latin American/African utilised more PPI compared with other ethnic groups.
Utilisation of PPI among older people in New Zealand increased by a fifth from 2005 to 2013. Given the concerns surrounding the long-term PPI use in older people, the appropriateness of the increased utilisation needs to be continuously re-evaluated by prescribers and health policy makers.
在国际上以及新西兰，用于治疗酸相关疾病的质子泵抑制剂（PPI）处方数量持续上升。人们对其在老年人中的广泛使用、成本及潜在不良反应表示担忧。
本研究旨在描述2005年至2013年新西兰老年人（65岁及以上）使用PPI的情况。
对2005年1月1日至2013年12月31日的人群层面配药数据进行重复横断面分析。2005年至2013年所有PPI处方的配药数据来自新西兰卫生部。使用世界卫生组织药物统计方法合作中心的解剖学、治疗学和化学分类系统，以每1000名老年人每天的限定日剂量（DDD）来衡量使用情况。使用情况按性别、年龄、种族和地区卫生委员会进行标准化。
从2005年到2013年，PPI的总体使用量增加了26.7%，从273.41 DDD/1000/天增至346.53 DDD/1000/天。在80至84岁的人群中观察到最高的使用量。与其他种族群体相比，中东/拉丁美洲/非洲裔使用的PPI更多。
从2005年到2013年，新西兰老年人中PPI的使用量增加了五分之一。鉴于对老年人长期使用PPI的担忧，处方医生和卫生政策制定者需要持续重新评估使用量增加的合理性。
