Felton Maria, Hanlon Joseph T, Perera Subashan, Thorpe Joshua M, Marcum Zachary A
School of Pharmacy at the University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Consult Pharm. 2015 Apr;30(4):240-5. doi: 10.4140/TCP.n.2015.240.
Few studies have examined racial differences in potentially inappropriate medication use. The objective of this study was to examine racial disparities in using prescription and/or nonprescription anticholinergics, a type of potentially inappropriate medication, over time.
Longitudinal.
Data from the Health, Aging, and Body Composition Study (years 1, 5, and 10).
Three thousand fifty-five community-dwelling older adults, both blacks and whites, at year 1.
Highly anticholinergic medication use per the 2012 American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.
Blacks represented 41.4% of the participants at year 1. At year 1, 13.4% of blacks used an anticholinergic medication compared with 17.8% of whites, and this difference persisted over the ensuing 10-year period. Diphenhydramine was the most common anticholinergic medication reported at baseline and year 5, and meclizine at year 10, for both races. Controlling for demographics, health status, and access to care factors, blacks were 24% to 45% less likely to use any anticholinergics compared with whites over the years considered (all P < 0.05).
The use of prescription and/or nonprescription anticholinergic medications was less common in older blacks than whites over a 10-year period, and the difference was unexplained by demographics, health status, and access to care.
很少有研究探讨潜在不适当用药方面的种族差异。本研究的目的是考察随着时间推移,在使用处方和/或非处方抗胆碱能药物(一种潜在不适当药物)方面的种族差异。
纵向研究。
来自健康、衰老和身体成分研究(第1年、第5年和第10年)的数据。
第1年时3055名居住在社区的老年人,包括黑人和白人。
根据2012年美国老年医学会更新的《老年人潜在不适当用药的Beers标准》来衡量高抗胆碱能药物的使用情况。
第1年时黑人占参与者的41.4%。第1年时,13.4%的黑人使用抗胆碱能药物,而白人的这一比例为17.8%,且在随后的10年期间这一差异持续存在。苯海拉明是两个种族在基线和第5年报告的最常见抗胆碱能药物,第10年时为美克洛嗪。在对人口统计学、健康状况和医疗服务可及性因素进行控制后,在研究的这些年份里,黑人使用任何抗胆碱能药物的可能性比白人低24%至45%(所有P<0.05)。
在10年期间,老年黑人使用处方和/或非处方抗胆碱能药物的情况比白人少见,且人口统计学、健康状况和医疗服务可及性无法解释这一差异。