Saudi Food and Drug Authority, Riyadh.
Medication Safety Research Chair, College of Pharmacy, King Saud University.
J Patient Saf. 2021 Dec 1;17(8):e1119-e1124. doi: 10.1097/PTS.0000000000000439.
Polypharmacy is very common in clinical practice, especially among adult patients. The use of multiple medications may increase the risk of adverse drug events, medication cost, and medication errors. In addition, polypharmacy exacerbates treatment complexity, which consequently leads to poor patients' adherence to their medications. Despite being a well-recognized problem, few studies have investigated the prevalence and predictors of polypharmacy in Saudi Arabia.
The aims of the study were to investigate the prevalence of polypharmacy among adult patients in a tertiary teaching hospital and to determine patients' characteristics that are associated with polypharmacy.
This was a retrospective cross-sectional study using data extracted from the electronic health records database for a period of 6 months between January and June 2016 in outpatient setting. Descriptive statistics were used to analyze the study sample. A multivariate logistic regression model was used to examine the association between different variables and polypharmacy. Statistical analysis software (SAS 9.2) was used to analyze the study data.
A total of 17,237 observations (67.2% females) were included in the final analysis. Of these, nearly 54% (n = 9222) of reported observations were found using up to four prescription drugs and the other 46% (n = 8015) were using five or more prescription drugs. Interestingly, the prevalence of polypharmacy use was doubled among adults with hypertension as compared with those without hypertension (odds ratio [OR] = 2.68, 95% confidence interval [CI] = 2.51-2.87). In addition, polypharmacy use was two times more prevalent among adults with diabetes as compared with those without diabetes (OR = 2.31, 95% CI = 1.99-2.28) and five times more prevalent in patient with dementia (OR = 5.57, 95% CI = 1.26-24.7). Moreover, polypharmacy in adult patients was significantly influenced by sex (OR = 1.69, 95% CI = 1.59-1.80) and nationality (OR = 2.15, 95% CI = 2.00-2.31).
Polypharmacy is common among adult patients especially those who are older than 60 years. Polypharmacy may affect the overall process of drug therapy. It can be a risk factor to develop undesirable adverse drug events, especially in those with chronic health conditions. A special care should be taken to manage polypharmacy among adults in Saudi Arabia.
在临床实践中,尤其是在成年患者中,多药治疗非常常见。使用多种药物可能会增加不良药物事件、药物成本和用药错误的风险。此外,多药治疗会加剧治疗的复杂性,从而导致患者对药物治疗的依从性降低。尽管这是一个公认的问题,但很少有研究调查沙特阿拉伯多药治疗的流行率和预测因素。
本研究旨在调查三级教学医院成年患者中多药治疗的流行率,并确定与多药治疗相关的患者特征。
这是一项回顾性横断面研究,使用了 2016 年 1 月至 6 月在门诊期间从电子健康记录数据库中提取的 6 个月的数据。使用描述性统计分析来分析研究样本。使用多变量逻辑回归模型来研究不同变量与多药治疗之间的关联。使用统计分析软件(SAS 9.2)来分析研究数据。
共有 17237 例观察结果(67.2%为女性)纳入最终分析。其中,近 54%(n=9222)的观察结果使用了 4 种以下处方药,而 46%(n=8015)的观察结果使用了 5 种或更多处方药。有趣的是,与无高血压的成年人相比,患有高血压的成年人使用多药治疗的比例增加了一倍(比值比[OR] = 2.68,95%置信区间[CI] = 2.51-2.87)。此外,与无糖尿病的成年人相比,患有糖尿病的成年人使用多药治疗的比例增加了两倍(OR = 2.31,95%CI = 1.99-2.28),而患有痴呆症的成年人则增加了五倍(OR = 5.57,95%CI = 1.26-24.7)。此外,多药治疗在成年患者中的流行率显著受到性别(OR = 1.69,95%CI = 1.59-1.80)和国籍(OR = 2.15,95%CI = 2.00-2.31)的影响。
多药治疗在成年患者中很常见,尤其是年龄在 60 岁以上的患者。多药治疗可能会影响整个药物治疗过程。它可能是发生不良药物事件的危险因素,特别是在患有慢性健康状况的患者中。在沙特阿拉伯,应特别注意管理成年人的多药治疗。