Holton Alice, Boland Fiona, Gallagher Paul, Fahey Tom, Kenny Rose Anne, Cousins Gráinne
School of Pharmacy, RCSI, St. Stephen's Green, Dublin 2, Ireland.
HRB Centre for Primary Care Research, RCSI, St. Stephen's Green, Dublin 2, Ireland.
Eur J Clin Pharmacol. 2019 Apr;75(4):569-575. doi: 10.1007/s00228-018-02608-7. Epub 2018 Dec 19.
This study aims to estimate (i) the prevalence of potentially serious alcohol-medication interactions in a nationally representative sample of older adults using the Potentially Serious Alcohol-Medication Interactions in Older adults (POSAMINO) criteria, and (ii) whether POSAMINO prevalence changes over time.
A prospective cohort study of adults aged ≥ 65 years, using data from the first three waves of The Irish Longitudinal Study on Ageing (TILDA). All 38 POSAMINO criteria were applied at each wave using respondents' information on regular medications and alcohol consumption. Multilevel logistic regression and negative binomial models were used to investigate whether the prevalence of POSAMINO varied over time.
The overall prevalence of POSAMINO was 18% at baseline, with 8% at risk of one potentially serious alcohol-medication interaction, and 10% at risk of two or more. The most common POSAMINO involved cardiovascular (CVS) agents (15% baseline; 11% wave 2; 14% wave 3), followed by central nervous system (CNS) agents (4% baseline; 4% wave 2; 5% wave 3). Prevalence of any POSAMINO (AOR 0.94, 95% CI 0.81, 1.08) or number of POSAMINO criteria (AIRR 0.97, 95% CI 0.91, 1.04) did not change over time. Any POSAMINO and number of POSAMINO were associated with younger age, male sex and number of medications and chronic conditions.
Potentially serious alcohol-medication interactions occurred in 18% of older adults in this study. Alcohol screening and brief interventions should be considered for high-risk groups at the point of prescribing, particularly among younger older adults, men and as patients receive more medications or develop additional illnesses.
本研究旨在估计：（i）使用老年人潜在严重酒精 - 药物相互作用（POSAMINO）标准，在具有全国代表性的老年人样本中潜在严重酒精 - 药物相互作用的患病率；以及（ii）POSAMINO患病率是否随时间变化。
一项针对年龄≥65岁成年人的前瞻性队列研究，使用来自爱尔兰老龄化纵向研究（TILDA）前三轮的数据。在每一轮中，根据受访者关于常规用药和饮酒情况的信息应用所有38条POSAMINO标准。使用多水平逻辑回归和负二项式模型来研究POSAMINO的患病率是否随时间变化。
基线时POSAMINO的总体患病率为18%，其中8%有发生一种潜在严重酒精 - 药物相互作用的风险，10%有发生两种或更多种相互作用的风险。最常见的POSAMINO涉及心血管（CVS）药物（基线时为15%；第2轮为11%；第3轮为14%），其次是中枢神经系统（CNS）药物（基线时为4%；第2轮为4%；第3轮为5%）。任何POSAMINO的患病率（比值比0.94，95%置信区间0.81，1.08）或POSAMINO标准的数量（发病率比0.97，95%置信区间0.91，1.04）均未随时间变化。任何POSAMINO及POSAMINO的数量与年龄较小、男性性别、用药数量和慢性病有关。
本研究中18%的老年人存在潜在严重酒精 - 药物相互作用。在开处方时，应考虑对高危人群进行酒精筛查和简短干预，特别是在年龄较小的老年人、男性中，以及当患者服用更多药物或患上其他疾病时。
