Vrettos Ioannis, Voukelatou Panagiota, Katsoras Apostolos, Theotoka Despoina, Kalliakmanis Andreas
2nd Department of Internal Medicine, General and Oncological Hospital of Kifissia "Agioi Anargyroi", Noufaron and Timiou Stavrou 14, Athens, Greece.
Curr Gerontol Geriatr Res. 2017;2017:4276047. doi: 10.1155/2017/4276047. Epub 2017 Dec 25.
Polypharmacy in several cases is deemed necessary and elderly patients are prone to this phenomenon. The objective of this study was to identify the prevalence and the predictors of polypharmacy among consecutively unplanned admissions of patients aged ≥65 years.
In 310 patients (51% women), mean age 80.24 years (95% CI 79.35-81.10), demographic characteristics, medical history, medications, and cause of admission were recorded. Parametric tests and multiple logistic regression analysis were applied to identify the factors that have significant association with polypharmacy.
53.5% of patients belonged to polypharmacy group. In multivariate analysis the independent predictors of polypharmacy were arterial hypertension ( = 0.003, OR = 2.708, and 95% CI 1.400-5.238), coronary artery disease ( = 0.001, OR = 8.274, and 95% CI 3.161-21.656), heart failure ( = 0.030, OR = 4.042, and 95% CI 1.145-14.270), atrial fibrillation ( = 0.031, OR = 2.477, and 95% CI 1.086-5.648), diabetes mellitus ( = 0.010, OR = 2.390, and 95% CI 1.232-4.636), dementia ( = 0.001, OR = 4.637, and 95% CI 1.876-11.464), and COPD ( = 0.022, OR = 3.626, and 95% CI 1.208-10.891).
Polypharmacy mainly was linked to cardiovascular diseases. If deprescribing is not feasible, physicians must oversee those patients in order to recognise early, possible drug reactions.
在某些情况下,多种药物联合使用被认为是必要的,而老年患者更容易出现这种现象。本研究的目的是确定65岁及以上患者连续非计划入院时多重用药的患病率及其预测因素。
记录了310例患者(51%为女性)的人口统计学特征、病史、用药情况及入院原因,平均年龄80.24岁(95%可信区间79.35 - 81.10)。采用参数检验和多因素logistic回归分析来确定与多重用药有显著关联的因素。
53.5%的患者属于多重用药组。在多变量分析中,多重用药的独立预测因素为动脉高血压(P = 0.003,比值比[OR]=2.708,95%可信区间1.400 - 5.238)、冠状动脉疾病(P = 0.001,OR = 8.274,95%可信区间3.161 - 21.656)、心力衰竭(P = 0.030,OR = 4.042,95%可信区间1.145 - 14.270)、心房颤动(P = 0.031,OR = 2.477,95%可信区间1.086 - 5.648)、糖尿病(P = 0.010,OR = 2.390,95%可信区间1.232 - 4.636)、痴呆(P = 0.001,OR = 4.637,95%可信区间1.876 - 11.464)和慢性阻塞性肺疾病(P = 0.022,OR = 3.626,95%可信区间1.208 - 10.891)。
多重用药主要与心血管疾病相关。如果减药不可行,医生必须对这些患者进行监测,以便早期识别可能的药物反应。