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瑞士多重用药状况变化的决定因素:基于人群的洛桑心脏研究

Determinants of change in polypharmacy status in Switzerland: the population-based CoLaus study.

作者信息

Abolhassani Nazanin, Castioni Julien, Marques-Vidal Pedro, Vollenweider Peter, Waeber Gérard

机构信息

Department of Medicine, Internal Medicine, Lausanne University Hospital, Office BH10-642, Rue du Bugnon 46, 1011, Lausanne, Switzerland.

出版信息

Eur J Clin Pharmacol. 2017 Sep;73(9):1187-1194. doi: 10.1007/s00228-017-2288-1. Epub 2017 Jun 21.

Abstract

OBJECTIVES

This study aimed to assess the prevalence, the change, and the determinants of change in polypharmacy in a population-based sample.

METHODS

Baseline (2003-2006) and follow-up (2009-2012) data are from 4679 participants aged between 35 and 75 years (53.5% women, mean age 52.6 ± 10.6 years) from the population of Lausanne, Switzerland. Polypharmacy was defined by the regular use of ≥5 drugs. Four categories of change were defined: never (no polypharmacy at baseline and follow-up), initiating (no polypharmacy at baseline but at follow-up), maintaining, or quitting.

RESULTS

Polypharmacy increased from 7.7% at baseline to 15.3% at follow-up. Cardiovascular drugs were the most prescribed medicines at baseline and follow-up. Gender, age, obesity, smoking, previously diagnosed hypertension, or diabetes or dyslipidemia were significantly and independently associated with initiating and maintaining polypharmacy.

CONCLUSION

In a population-based sample, prevalence of polypharmacy doubled over a 5.6-year period. The main determinants of initiating polypharmacy were age, overweight and obesity, smoking status, and previously diagnosed cardiovascular risk factors.

摘要

目的

本研究旨在评估基于人群样本中多重用药的患病率、变化情况及其变化的决定因素。

方法

基线数据(2003 - 2006年)和随访数据(2009 - 2012年)来自瑞士洛桑人群中4679名年龄在35至75岁之间的参与者(女性占53.5%,平均年龄52.6±10.6岁)。多重用药定义为规律使用≥5种药物。定义了四类变化:从未(基线和随访时均无多重用药)、开始(基线时无多重用药但随访时有)、维持或停止。

结果

多重用药率从基线时的7.7%增至随访时的15.3%。心血管药物是基线和随访时处方最多的药物。性别、年龄及肥胖、吸烟、既往诊断的高血压、糖尿病或血脂异常与开始和维持多重用药显著且独立相关。

结论

在基于人群的样本中,多重用药患病率在5.6年期间翻倍。开始多重用药的主要决定因素是年龄、超重和肥胖、吸烟状况以及既往诊断的心血管危险因素。

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