沙特阿拉伯一家三级医院的糖尿病患者多药治疗：一项横断面回顾性研究。
Polypharmacy among patients with diabetes: a cross-sectional retrospective study in a tertiary hospital in Saudi Arabia.
机构信息
Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
出版信息
BMJ Open. 2018 May 24;8(5):e020852. doi: 10.1136/bmjopen-2017-020852.
UNLABELLED
ObjectivesPatients with diabetes are at high risk for polypharmacy (ie, use of multiple medications) for treatment of diabetes, associated comorbidities and other coexisting conditions. This study aims to estimate the prevalence of polypharmacy and factors associated with polypharmacy among adult patients with diabetes.
METHODS
A cross-sectional retrospective observational study of adults with diabetes, who visited the outpatient clinic of a tertiary teaching hospital in Saudi Arabia, was conducted. Data were extracted from the Electronic Health Record database for a period of 12 months (January-December 2016). Polypharmacy was defined as the cumulative use of five or more medications. Polypharmacy among adults with diabetes was measured by calculating the average number of medications prescribed per patient. A multivariable logistic regression model was used to examine the factors associated with polypharmacy.
RESULTS
A total of 8932 adults with diabetes were included in this study. Of these, nearly 78% had polypharmacy which was more likely among women as compared with men and more likely among older adults (age ≥60 years) as compared with the adults. Also, polypharmacy was two times as likely among patients with coexisting cardiovascular conditions (adjusted OR (AOR)=2.89; 95% CI 2.54 to 3.29), respiratory disease (AOR=2.42; 95% CI 1.92 to 3.03) and mental health conditions (AOR=2.19; 95% CI 1.74 to 2.76), and three times as likely among patients with coexisting musculoskeletal disease (AOR=3.16; 95% CI 2.31 to 4.30) as compared with those without these coexisting chronic conditions categories.
CONCLUSIONS
Polypharmacy is common among patients with diabetes, with an even higher rate in older adults patients. Healthcare providers can help in detecting polypharmacy and in providing recommendations for simplifying medication regimens and minimising medications to enhance the outcome of diabetes care.
目的
患有糖尿病的患者由于需要治疗糖尿病、相关合并症和其他共存病症，因此存在多种药物并用（即使用多种药物）的高风险。本研究旨在评估成年糖尿病患者中并用药物的流行率以及与并用药物相关的因素。
方法
这是一项在沙特阿拉伯一家三级教学医院的门诊就诊的成年糖尿病患者中进行的横断面回顾性观察性研究。研究期间为 12 个月（2016 年 1 月至 12 月），数据从电子健康记录数据库中提取。并用药物定义为累计使用五种或更多种药物。通过计算每位患者开具的药物平均数量来衡量成年糖尿病患者中的并用药物情况。使用多变量逻辑回归模型来检查与并用药物相关的因素。
结果
本研究共纳入 8932 名成年糖尿病患者。其中，近 78%的患者并用药物，女性患者比男性患者更有可能并用药物，老年患者（年龄≥60 岁）比成年患者更有可能并用药物。此外，与无共存心血管疾病、呼吸系统疾病或心理健康状况的患者相比，患有共存心血管疾病（校正比值比（AOR）=2.89；95%CI 2.54 至 3.29）、呼吸系统疾病（AOR=2.42；95%CI 1.92 至 3.03）和心理健康状况（AOR=2.19；95%CI 1.74 至 2.76）的患者并用药物的可能性是前者的两倍，患有共存肌肉骨骼疾病（AOR=3.16；95%CI 2.31 至 4.30）的患者则是前者的三倍。
结论
糖尿病患者中并用药物很常见，老年患者的发生率更高。医疗保健提供者可以帮助发现并用药物，并提供简化药物治疗方案和减少药物的建议，以改善糖尿病治疗的结果。
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