Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine, 37 allées Jules Guesde, 31000, Toulouse, France.
UMR INSERM 1027, Faculté de Médecine, Université Paul-Sabatier, 37 allées Jules Guesde, 31000, Toulouse, France.
Fundam Clin Pharmacol. 2019 Aug;33(4):471-478. doi: 10.1111/fcp.12450. Epub 2019 Feb 14.
Atropinic drugs are known to potentially induce physical and/or mental impairments in the elderly. The aim of this study was to investigate trends of atropinic exposure in patients ≥65 years in France between 2006 and 2015. A repeated cross-sectional study was performed quarterly from January 1, 2006 to December 31, 2015, in the 'Echantillon Généraliste des Bénéficiaires (EGB)', a representative sample of the French population. Exposed patients were identified using the Anticholinergic Durán's list. Outcomes were rate of patients exposed to at least one atropinic drug (atropinic prevalence rate) and atropinic burden per patient (sum of atropinic burden scores). Interrupted time series were used to analyze the impact of market withdrawal of some drugs with atropinic properties during the period of the study. The number of patients ≥65 years registered in the EGB ranged from 75 611 in 2006 to 95 389 in 2015. Atropinic prevalence rate decreased significantly from 45.6% in 2006 to 33.2% in 2015 (-12.4%, slope significance P < 0.05). Subjects aged ≥85 years were the most exposed. Total atropinic burden decreased significantly between 2006 and 2015 (2.2 ± 1.7 in 2006; 2.0 ± 1.5 in 2015; slope significance P < 0.05), especially in patients ≥85 years. Market withdrawals for safety reasons of some atropinic drugs were significantly associated with a decrease in the atropinic prevalence rate (P < 0.05) and atropinic burden per patient (P < 0.05). In conclusion, atropinic drug exposure in the elderly significantly decreased in France between 2006 and 2015. This decrease can be partly explained by regulatory measures against some atropinic drugs.
阿托品类药物已知会对老年人的身体和/或精神造成损害。本研究的目的是调查 2006 年至 2015 年期间法国 65 岁以上患者中阿托品类药物的暴露趋势。从 2006 年 1 月 1 日至 2015 年 12 月 31 日，每季度进行一次重复横断面研究，研究对象是法国人口的代表性样本“Echantillon Généraliste des Bénéficiaires（EGB）”。使用抗胆碱能 Durán 列表识别暴露于阿托品类药物的患者。结果为至少使用一种阿托品类药物的患者比例（阿托品类药物流行率）和每位患者的阿托品类药物负担（阿托品类药物负担评分总和）。中断时间序列用于分析研究期间一些具有阿托品类特性的药物撤出市场对该期间的影响。2006 年 EGB 登记的 65 岁以上患者人数从 2006 年的 75611 人增加到 2015 年的 95389 人。2006 年阿托品类药物流行率为 45.6%，2015 年降至 33.2%（下降 12.4%，斜率意义 P < 0.05）。年龄≥85 岁的患者暴露率最高。2006 年至 2015 年期间，总阿托品类药物负担显著下降（2006 年 2.2 ± 1.7；2015 年 2.0 ± 1.5；斜率意义 P < 0.05），尤其是≥85 岁的患者。出于安全原因撤出一些具有阿托品类特性的药物与阿托品类药物流行率（P < 0.05）和每位患者的阿托品类药物负担（P < 0.05）下降显著相关。总之，2006 年至 2015 年期间，法国老年人使用阿托品类药物的情况显著减少。这种减少可以部分解释为针对某些阿托品类药物的监管措施。
