2006 年至 2016 年期间澳大利亚老年人群降压药物的配给模式。

Dispensing Patterns of Blood Pressure Lowering Agents in Older Australians From 2006 to 2016.

机构信息

1 School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

2 NHMRC Centre of Research Excellence in Cardiovascular Outcomes Improvement, Curtin University, Perth, Australia.

出版信息

J Cardiovasc Pharmacol Ther. 2019 May;24(3):242-250. doi: 10.1177/1074248418812184. Epub 2018 Nov 21.

DOI:10.1177/1074248418812184

PMID:30463435

Abstract

BACKGROUND

Increasing numbers of blood pressure lowering (BPL) agents are being prescribed for both primary and secondary prevention of cardiovascular disease, especially in the older population. The aim of this study is to describe the temporal trends and patterns of BPL dispensing among older Australians (aged ≥65 years).

METHODS

We utilized prescription claims data from the Australian Pharmaceutical Benefits Scheme (PBS) for a 10% random sample of people aged ≥65 years. The PBS, funded by the Federal government, provides subsidies to make medicines more affordable for Australian residents. We restricted our analysis to "long-term concession" individuals, who would use PBS for the majority of their medication needs. BPL agents were identified using the World Health Organization Anatomical Therapeutic Chemical classification codes. The annual prevalences and proportional distributions of BPL dispensing by categories were summarized from 2006 to 2016. Direct standardization was applied to indicate changes of BPL dispensing over time.

RESULTS

Age-standardized dispensing of BPL agents increased by 8% among older Australians from 2006 to 2016 (58%-66%). BPL dispensing in males has exceeded that in females since 2009. Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers were the dominant BPL agents dispensed, with more than 55% of all BPL users over time. Dispensing of diuretics decreased from 27% to 21%, calcium channel blockers decreased from 30% to 25%, while β-blockers remained stable (29%-31%). The use of fixed-dose combinations increased over time from 23% to 31%.

CONCLUSION

The prevalence of BPL dispensing steadily increased among older Australians from 2006 to 2016. The changes in the patterns of BPL dispensing were largely in line with contemporary changes to clinical guidelines for an aging population.

摘要

背景

越来越多的降压药物（BPL）被用于心血管疾病的一级和二级预防，尤其是在老年人群中。本研究旨在描述澳大利亚老年人（年龄≥65 岁）中 BPL 配药的时间趋势和模式。

方法

我们利用澳大利亚药品福利计划（PBS）的处方数据，对≥65 岁人群的 10%随机样本进行了分析。PBS 由联邦政府资助，为澳大利亚居民提供药品补贴，以降低药品价格。我们将分析仅限于“长期优惠”人群，他们将使用 PBS 满足大部分药物需求。BPL 药物通过世界卫生组织解剖治疗化学分类代码进行识别。总结了 2006 年至 2016 年 BPL 配药的年度流行率和分类比例分布。直接标准化用于表示随时间推移 BPL 配药的变化。

结果

2006 年至 2016 年，澳大利亚老年人的 BPL 药物配药率标准年龄标准化后增加了 8%（58%-66%）。自 2009 年以来，男性的 BPL 配药率超过了女性。血管紧张素转换酶抑制剂/血管紧张素 II 受体阻滞剂是最主要的 BPL 药物，随着时间的推移，超过 55%的 BPL 用户都在使用这些药物。利尿剂的配药率从 27%下降到 21%，钙通道阻滞剂从 30%下降到 25%，而β受体阻滞剂保持稳定（29%-31%）。固定剂量组合的使用随着时间的推移从 23%增加到 31%。