Istituti Clinici Zucchi, Carate, Italy; Department of Clinical Sciences and Community Health, University of Milan, Italy.
Department of Medicine and Surgery, University of Milano-Bicocca, Italy.
Public Health. 2016 Dec;141:26-31. doi: 10.1016/j.puhe.2016.08.009. Epub 2016 Sep 15.
This study was carried out with two objectives. The first one was to have an insight into the prevalence of chronic noncommunicable diseases (CNCD) in undocumented migrants, and the second one was to evaluate if differences existed among different ethnic groups.
The study is based on the collection of data on drug dispensation by a non-governmental organization (NGO) providing free medical assistance to undocumented migrants in Milan, Italy. All the prescriptions to adult subjects from January 1 to December 31 2014 (total 8438) were recorded and analyzed. All the data available for the patients receiving prescriptions (age, gender and country of birth) were also collected in anonymous form. Ethical approval for the study was given by the Ethics Committee of the NGO.
Drugs were grouped according to the anatomical therapeutic chemical (ATC) classification and their quantities expressed as daily defined doses (DDDs)/1000 patients/day. The 56 ATC levels were divided into three groups according to their use for acute, chronic, or both acute and chronic diseases. The statistical analysis of drug dispensation was performed for the whole population and for the five ethnic groups into which it had been divided.
Prescription of medicines for chronic conditions was significantly greater than for acute (154.2 ± 45.9 vs 51.3 ± 18.4 DDD/1000 patients/day, P < 0.02) and for both acute and chronic conditions (57.9 ± 12.8 DDD/1000 patients/day, P < 0.02). Five ATC classes accounted for 60% of all chronic prescriptions. They were differently distributed among the five ethnic groups (e.g., Asians required more antihypertensives and antidiabetics, East Europeans required more lipid modifying drugs, antihypertensives and antithrombotics).
Our data show an important use of medicines for chronic diseases in a population of undocumented migrants. Though with some limitations, this could be an indicator of a high prevalence of CNCD in this population, with significant differences among different ethnic groups. This situation should be considered when planning health interventions, also in consideration of the fact that it could have an impact on European Health Services in a short time.
本研究旨在实现两个目标。第一个目标是深入了解无证移民中慢性非传染性疾病（CNCD）的流行情况，第二个目标是评估不同族裔群体之间是否存在差异。
本研究基于一家非政府组织（NGO）收集的数据，该组织在意大利米兰为无证移民提供免费医疗援助。记录并分析了 2014 年 1 月 1 日至 12 月 31 日期间向成年患者开具的所有处方（共 8438 份）。还以匿名形式收集了所有可用于接受处方的患者（年龄、性别和出生国）的数据。该研究的伦理批准由 NGO 的伦理委员会授予。
根据解剖治疗化学（ATC）分类对药物进行分组，并将其数量表示为每日规定剂量（DDD）/1000 名患者/天。根据其用于急性、慢性或急性和慢性疾病的用途，将 56 个 ATC 级别分为三组。对整个人群和分为五个族裔群体的人群进行药物分配的统计分析。
治疗慢性疾病的药物处方明显多于治疗急性疾病（154.2±45.9 与 51.3±18.4 DDD/1000 名患者/天，P<0.02）和急性和慢性疾病（57.9±12.8 DDD/1000 名患者/天，P<0.02）。五类 ATC 类别占所有慢性处方的 60%。它们在五个族裔群体中的分布不同（例如，亚洲人需要更多的降压药和降糖药，东欧人需要更多的调脂药、降压药和抗血栓药）。
我们的数据显示，无证移民人群中大量使用治疗慢性疾病的药物。尽管存在一些限制，但这可能表明该人群中 CNCD 的患病率较高，不同族裔群体之间存在显著差异。在规划卫生干预措施时应考虑到这种情况，还应考虑到这种情况可能会在短时间内对欧洲卫生服务产生影响。
