老年患者受教育程度对多种药物治疗、Beer 标准列出的潜在不适当药物以及非计划性住院的影响：巴基斯坦拉合尔的一项横断面研究。
Influence of Education Level of Older Patients on Polypharmacy, Potentially Inappropriate Medications Listed in Beer's Criteria, and Unplanned Hospitalization: A Cross-Sectional Study in Lahore, Pakistan.
机构信息
Department of Pharmacy, The Islamia University of Bahawalpur, Punjab 63100, Pakistan.
Department of Pharmacy Practice, Akhtar Saeed College of Pharmaceutical Sciences, Lahore 54000, Pakistan.
出版信息
Medicina (Kaunas). 2018 Aug 24;54(4):57. doi: 10.3390/medicina54040057.
: To evaluate influence of education level of older patients on polypharmacy, potentially inappropriate medications (PIMs) listed in Beer's Criteria, and unplanned hospitalization. : A cross-sectional study was conducted among older people aged ≥65 years between 1 December 2017 and 28 February 2018. For data analysis, descriptive statistics and logistic regression analysis were employed. : Among 385 older patients, 88.8% were prescribed PIMs and 56.4% underwent PIMs associated unplanned hospitalization. Older people were less exposed to polypharmacy or excessive polypharmacy as their education levels increased (no formal education vs. primary vs. secondary vs. tertiary, 74% vs. 69.8% vs. 60.5% vs. 58.1%). Patients having higher education were also accompanied by significantly lower prescription of PIMs (no formal education vs. primary vs. secondary vs. tertiary, 96% vs. 87.3% vs. 84.5% vs. 79.1%) as well as unplanned hospitalization (no formal education vs. primary vs. secondary vs. tertiary, 64.7% vs. 76.2% vs. 40.3% vs. 46.5%). Results of regression analysis revealed that no formal education (OR = 1.202, 95% CI = 1.032⁻2.146, -value = 0.003) and primary education level (OR = 1.175, 95% CI = 1.014⁻1.538, -value = 0.039) were significantly associated with the use of polypharmacy among older people. On the other hand, no formal education was significantly associated with the prescription of PIMs (OR = 1.898, 95% CI = 1.151⁻2.786, -value = 0.007). Furthermore, older people with no formal education (OR = 1.402, 95% CI = 1.123⁻1.994, -value = 0.010) and primary education level (OR = 1.775, 95% CI = 1.281⁻3.018, -value = <0.001) were significantly more likely to undergo unplanned hospitalization. Patients having low literacy level are more likely to receive PIMs, polypharmacy, and undergo unplanned hospitalization in comparison to highly educated patients. Hence, promotion of health literacy for patients is crucial to overcome these problems.
: 为了评估老年患者的教育水平对多药治疗、Beer 标准列出的潜在不适当药物 (PIMs) 和非计划性住院的影响。: 2017 年 12 月 1 日至 2018 年 2 月 28 日期间，对年龄≥65 岁的老年人进行了一项横断面研究。数据分析采用描述性统计和逻辑回归分析。: 在 385 名老年患者中，88.8%的患者服用了 PIMs，56.4%的患者因 PIMs 而接受了非计划性住院治疗。随着教育水平的提高，老年人接受多药治疗或过度多药治疗的可能性越低（未受过正规教育者 vs. 小学教育者 vs. 中学教育者 vs. 高等教育者，74% vs. 69.8% vs. 60.5% vs. 58.1%）。受教育程度较高的患者，开具 PIMs 的处方也明显减少（未受过正规教育者 vs. 小学教育者 vs. 中学教育者 vs. 高等教育者，96% vs. 87.3% vs. 84.5% vs. 79.1%），非计划性住院的可能性也较低（未受过正规教育者 vs. 小学教育者 vs. 中学教育者 vs. 高等教育者，64.7% vs. 76.2% vs. 40.3% vs. 46.5%）。回归分析结果显示，未受过正规教育（OR = 1.202，95%CI = 1.032-2.146，-值=0.003）和小学教育程度（OR = 1.175，95%CI = 1.014-1.538，-值=0.039）与老年人多药治疗显著相关。另一方面，未受过正规教育与 PIMs 的处方显著相关（OR = 1.898，95%CI = 1.151-2.786，-值=0.007）。此外，未受过正规教育（OR = 1.402，95%CI = 1.123-1.994，-值=0.009）和小学教育程度（OR = 1.775，95%CI = 1.281-3.018，-值=0.001）的老年人更有可能接受非计划性住院治疗。与高学历患者相比，文化程度较低的患者更有可能接受 PIMs、多药治疗和非计划性住院治疗。因此，促进患者的健康素养对于解决这些问题至关重要。
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