Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Sanei Clinic, Komaki, Aichi, Japan.
Geriatr Gerontol Int. 2018 Jan;18(1):33-41. doi: 10.1111/ggi.13132. Epub 2017 Aug 8.
Polypharmacy, which is often observed in elderly patients, has been associated with several unfavorable outcomes, including an increased risk of potentially inappropriate medications, medication non-adherence, drug duplication, drug-drug interactions, higher healthcare costs and adverse drug reactions. A significant association between polypharmacy and adverse outcomes among older people living in the community has also been confirmed. A reduction in the number of medications should thus be pursued for many older individuals. Nevertheless, the factors associated with polypharmacy in elderly home-care patients have not been reported. Here, we investigated those factors in elderly home-care patients in Japan.
We used the data of the participants in the Observational Study of Nagoya Elderly with Home Medical investigation. Polypharmacy was defined as the current use of six or more different medications. We carried out univariate and multivariate logistic regression analyses to assess the associations between polypharmacy and each of several factors.
A total of 153 home-care patients were registered. The mean number of medications used per patient was 5.9, and 51.5% of the patients belonged to the polypharmacy group. The multivariate model showed that the patients' scores on the Charlson Comorbidity Index and the Mini-Nutrition Assessment Short Form were inversely associated with polypharmacy, and potentially inappropriate medication was most strongly associated with polypharmacy (odds ratio 4.992).
The present findings showed that polypharmacy was quite common among the elderly home-care patients, and they suggest that home-care physicians should prescribe fewer medications in accord with the deterioration of home-care patients' general condition. Geriatr Gerontol Int 2018; 18: 33-41.
在老年患者中经常观察到的多种药物治疗与多种不良结局相关，包括潜在不适当药物的风险增加、药物不依从、药物重复、药物-药物相互作用、更高的医疗保健成本和药物不良反应。社区中老年人的多种药物治疗与不良结局之间也存在显著关联。因此，许多老年人都应减少用药数量。然而，老年家庭护理患者中多种药物治疗的相关因素尚未报道。在这里，我们调查了日本老年家庭护理患者的这些因素。
我们使用名古屋老年家庭医疗调查参与者的数据。多种药物治疗定义为当前使用六种或更多种不同药物。我们进行了单变量和多变量逻辑回归分析，以评估多种药物治疗与几种因素之间的关联。
共登记了 153 名家庭护理患者。每位患者平均使用的药物数量为 5.9 种，51.5%的患者属于多种药物治疗组。多变量模型显示，患者的 Charlson 合并症指数和 Mini-Nutrition 评估简表得分与多种药物治疗呈负相关，潜在不适当药物与多种药物治疗的关联最强（比值比 4.992）。
本研究结果表明，老年家庭护理患者中多种药物治疗非常常见，这表明家庭护理医生应根据家庭护理患者一般状况的恶化减少用药。老年医学与老年病学国际 2018; 18: 33-41.
