E. U. Enfermería y Fisioterapia de Toledo, Universidad de Castilla-La Mancha, Toledo, Spain.
Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.
J Clin Nurs. 2018 Aug;27(15-16):2942-2952. doi: 10.1111/jocn.14371. Epub 2018 May 28.
To analyse the prevalence, risk factors and evolution over time of polypharmacy and self-medication in the older people in Spain from 2006-2014.
Polypharmacy is a public health problem for older people worldwide which causes different negative effects on their health, increasing health costs and pharmaceutical spending. However, previous studies do not include nationally representative samples and none of them provide updated data.
Cross-sectional study with community-dwelling older adults (N = 26,277) who participated in the National Health Survey in Spain in 2006 and 2011/2012 and the European Health Survey in Spain in 2009 and 2014.
Polypharmacy (defined as use of five or more medications in the last 2 weeks), excessive polypharmacy (defined as use of ten or more medications in the last 2 weeks) and self-medication (defined as use of medications without a prescription) were evaluated. A logistic regression was used for to know the association between polypharmacy and self-medication with the sociodemographic characteristic.
The participants were 62% female and 38% male. The mean medication consumption was 2.96 (SD ± 2.11). Prevalence of polypharmacy was present in 21.9%, prevalence of excessive polypharmacy was 0.6%, and prevalence of self-medication was 10.7%. The most commonly used medications were for blood pressure (51.6%), pain (42.8%) and cholesterol (28.2%). Polypharmacy is associated with sex (females), age, being separated/divorced/widowed, lack of education, higher body mass index, being bedridden during the last 2 weeks and self-medication.
The prevalence of polypharmacy and prevalence of self-medication are considerable, and they increased significantly from 2006-2014.
To deal with polypharmacy is a big challenge for nurses. These data suggest to establish innovative clinical strategies in which the health professionals and the patients are involved to improve the personal behaviour with medicines and to reduce the risks and costs of polypharmacy and self-medication.
分析 2006-2014 年西班牙老年人中普遍存在的、与时间相关的、药物使用过多和自我用药的流行率、风险因素及演变情况。
药物使用过多是全球老年人的一个公共卫生问题，对他们的健康造成了不同的负面影响，增加了健康成本和药品支出。然而，以前的研究没有包括全国代表性的样本，也没有提供最新的数据。
2006 年和 2011/2012 年参加西班牙全国健康调查的社区居住老年人（N=26277）以及 2009 年和 2014 年参加西班牙欧洲健康调查的老年人为研究对象，进行了一项横断面研究。
评估了药物使用过多（定义为过去 2 周内使用五种或更多种药物）、过度药物使用过多（定义为过去 2 周内使用十种或更多种药物）和自我用药（定义为未经处方使用药物）。使用逻辑回归来了解药物使用过多和自我用药与社会人口统计学特征之间的关联。
参与者中 62%为女性，38%为男性。平均用药量为 2.96（标准差±2.11）。药物使用过多的患病率为 21.9%，过度药物使用过多的患病率为 0.6%，自我用药的患病率为 10.7%。最常用的药物是用于治疗血压（51.6%）、疼痛（42.8%）和胆固醇（28.2%）的药物。药物使用过多与性别（女性）、年龄、离异/丧偶/鳏居、缺乏教育、较高的体重指数、过去 2 周卧床以及自我用药有关。
药物使用过多和自我用药的患病率相当高，且从 2006-2014 年显著增加。
应对药物使用过多对护士来说是一个巨大的挑战。这些数据表明，需要制定创新的临床策略，让卫生专业人员和患者参与其中，以改善个人用药行为，降低药物使用过多和自我用药的风险和成本。
