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[葡萄牙波尔图65岁以上人群的药物消费与潜在不适当用药处方风险]

[Consumption of drugs in over 65 in Porto (Portugal) and risk of potentially inappropriate medication prescribing].

作者信息

Eiras Andreia, Teixeira M Antonieta, González-Montalvo Juan I, Castell Maria-Victoria, Queipo Rocio, Otero Ángel

机构信息

Unidade de Saúde Familiar Rainha D. Amélia, Oporto, Portugal.

Unidade de Saúde Familiar Rainha D. Amélia, Oporto, Portugal.

出版信息

Aten Primaria. 2016 Feb;48(2):110-20. doi: 10.1016/j.aprim.2015.03.005. Epub 2015 May 23.

Abstract

OBJECTIVE

To determine medication consumption in the older people from a central area of Oporto; determine the prevalence of prescription of Potentially Inappropriate Medication and to analyse the polypharmacy and other important connected factors.

DESIGN, SETTING AND PATIENTS: Cross-sectional study with a sample of 747 patients older than 64 years, who were attended in a Primary care health centre: USF Rainha D. Amélia, Oporto, Portugal.

MAIN OUTCOME MEASURES

identification of all medication prescribed from electronic registers. Polypharmacy was considered more than 5 medication prescribed and Potential Inappropriate Medication was identified by Beers criteria 2012. The socio-demographic factors, diagnosis and health care services use were registered too. Logistic regression analysis was used to determine the association between co-variables.

RESULTS

There were 89.2% (95%CI: 87.6-92.0) of the studied population with at least one prescription. The polypharmacy was present at 59.2% (95%CI: 55.7-62.7) of people. The Potential Inappropriate Medication was present in 37.0% (95%CI: 33.5-40.5) of the cases. The Potential Inappropriate Medication was related with increasing age [OR=1.02 (95%CI: 1.00-1.05)], polypharmacy [OR=4.45 (95%CI: 3.12-6.36)], and be diagnosed with depression/anxiety [OR=2.18 (95%CI: 1.36-3.51)] and/or arthrosis [OR=1.64 (95%CI: 1.11-2.42)].

CONCLUSION

The rate of medication prescription, polypharmacy and the prescription of Potentially Inappropriate Medication are very high in Portuguese population studied. The polypharmacy is the most important factor related with this potential inappropriate medication. The physician need to have carefully with prescription of the anxiolytic and anti-inflammatory pain drugs.

摘要

目的

确定波尔图市中心地区老年人的用药情况;确定潜在不适当用药的处方率,并分析多重用药情况及其他重要相关因素。

设计、地点和患者:对葡萄牙波尔图市圣多美·阿梅莉亚初级保健健康中心就诊的747名64岁以上患者进行横断面研究。

主要观察指标

从电子记录中识别所有开具的药物。多重用药定义为开具5种以上药物,潜在不适当用药根据2012年Beers标准确定。还记录了社会人口学因素、诊断情况和医疗服务使用情况。采用逻辑回归分析确定协变量之间的关联。

结果

89.2%(95%置信区间:87.6 - 92.0)的研究人群至少有一张处方。59.2%(95%置信区间:55.7 - 62.7)的人存在多重用药情况。37.0%(95%置信区间:33.5 - 40.5)的病例存在潜在不适当用药情况。潜在不适当用药与年龄增长[比值比=1.02(95%置信区间:1.00 - 1.05)]、多重用药[比值比=4.45(95%置信区间:3.12 - 6.36)]、被诊断为抑郁/焦虑[比值比=2.18(95%置信区间:1.36 - 3.51)]和/或关节炎[比值比=1.64(95%置信区间:1.11 - 2.42)]有关。

结论

在所研究的葡萄牙人群中,药物处方率、多重用药情况和潜在不适当用药的处方率都非常高。多重用药是与这种潜在不适当用药相关的最重要因素。医生在开具抗焦虑药和抗炎镇痛药时需要谨慎。

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