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抗帕金森病药物(APD)使用者中使用诱发跌倒风险药物的情况:一项基于瑞典登记处的研究

Use of Fall-Risk Inducing Drugs in Patients Using Anti-Parkinson Drugs (APD): A Swedish Register-Based Study.

作者信息

Haasum Ylva, Fastbom Johan, Johnell Kristina

机构信息

Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.

出版信息

PLoS One. 2016 Aug 18;11(8):e0161246. doi: 10.1371/journal.pone.0161246. eCollection 2016.

Abstract

OBJECTIVES

Many drugs increase the risk of falls in old age. Although persons with Parkinson's disease (PD) are at increased risk of experiencing falls and fractures, the use of fall-risk inducing drugs (FRIDs) in this population has not previously been investigated. The objective of this study was to investigate the burden of use of FRIDs in older persons treated with anti-Parkinson drugs (APD; used as a proxy for PD), compared to persons without APD.

METHODS

We analyzed individual data on age, sex, type of housing and drug use in 1 346 709 persons aged ≥ 65 years in the Swedish Prescribed Drug Register on the date of 30 September 2008. Main outcome measure was the use of FRIDs.

RESULTS

FRIDs were used by 79% of persons with APD and 75% of persons without APD. Persons with APD were more likely to use ≥ 1 FRIDs compared to persons without APD (adjusted OR: 1.09; 95% CI: 1.06-1-12). The association was stronger for concomitant use of ≥ 5 FRIDS (adjusted OR: 1.49; 95% CI: 1.44-1.55).

CONCLUSIONS

The high use of FRIDs among persons with APD indicates that these patients may be at increased risk of drug-induced falls. Further studies are needed to investigate how these drugs affect the risk of falling in persons with PD.

摘要

目的

许多药物会增加老年人跌倒的风险。尽管帕金森病(PD)患者跌倒和骨折的风险增加,但此前尚未对该人群中使用诱发跌倒风险药物(FRIDs)的情况进行研究。本研究的目的是调查与未使用抗帕金森药物(APD;用作PD的替代指标)的人群相比,使用APD治疗的老年人中FRIDs的使用负担。

方法

我们分析了瑞典处方药登记册中2008年9月30日年龄≥65岁的1346709人的年龄、性别、住房类型和药物使用的个体数据。主要结局指标是FRIDs的使用情况。

结果

79%使用APD的人和75%未使用APD的人使用了FRIDs。与未使用APD的人相比,使用APD的人更有可能使用≥1种FRIDs(校正比值比:1.09;95%置信区间:1.06 - 1.12)。对于同时使用≥5种FRIDs的情况,这种关联更强(校正比值比:1.49;95%置信区间:1.44 - 1.55)。

结论

使用APD的人群中FRIDs的高使用率表明这些患者药物诱发跌倒的风险可能增加。需要进一步研究来调查这些药物如何影响PD患者的跌倒风险。

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