2007 年和 2013 年养老院居民的便秘和泻药使用情况。
Constipation and laxative use among people living in nursing homes in 2007 and 2013.
机构信息
Department of Pharmacology and Clinical Neuroscience, Umeå University, SE-901 87, Umeå, Sweden.
Department of Nursing, Umeå University, 901 87, Umeå, Sweden.
出版信息
BMC Geriatr. 2019 Feb 8;19(1):38. doi: 10.1186/s12877-019-1054-x.
BACKGROUND
Constipation is a common condition among older people, particularly among people living in nursing homes, and the use of drugs such as opioids is one of many factors that contribute to its high prevalence. The aim of this study was to compare the prevalence of constipation and the use of laxatives between 2007 and 2013, to analyze constipation and laxative use among people who are prescribed opioids, and to identify factors associated with constipation.
METHODS
In 2007 and 2013, two surveys were performed in the county of Västerbotten in Northern Sweden, comprising all those living in nursing homes. The Multi-Dimensional Dementia Assessment Scale was used to collect data regarding laxative, opioid and anticholinergic drug use, functioning in activities of daily living (ADL), cognition and symptoms of constipation. A comparison was made between 2820 people from 2007 and 1902 people from 2013.
RESULTS
The prevalence of symptoms of constipation among people living in nursing homes increased from 36% in 2007 to 40% in 2013. After controlling for age, sex, ADL, cognitive impairment and use of opioid and anticholinergic drugs, this difference was found to be statistically significant. When controlled for demographic changes, there was a statistically significant difference in the regular use of laxatives between the respective years, from 46% in 2007 to 59% in 2013. People prescribed opioids and anticholinergic drugs were at increased risk of constipation, while people with a higher ADL score were at decreased risk. Further, among people prescribed opioids and rated as constipated, 35% in 2007 and 20% in 2013 were not prescribed laxatives for regular use, a difference that was found to be statistically significant.
CONCLUSIONS
The prevalence of symptoms of constipation increased between 2007 and 2013. Although there was a decrease between the years, there were still a number of people being prescribed with opioids and rated as constipated who were not treated with laxatives. This study therefore indicates that constipation remains a significant problem among people in nursing homes and also indicates that those prescribed opioids could benefit from an increased awareness of the risk of constipation and treatment, if required.
背景
便秘是老年人的常见病症，尤其是居住在养老院的老年人，而阿片类药物等药物的使用是导致其高发的众多因素之一。本研究旨在比较 2007 年至 2013 年期间便秘和泻药使用的流行率，分析开处阿片类药物人群的便秘和泻药使用情况，并确定与便秘相关的因素。
方法
2007 年和 2013 年，在瑞典北部的韦斯特博滕县进行了两次调查，涵盖了所有居住在养老院的人。使用多维痴呆评估量表收集有关泻药、阿片类药物和抗胆碱能药物使用、日常生活活动（ADL）、认知和便秘症状的数据。对 2007 年的 2820 人和 2013 年的 1902 人进行了比较。
结果
养老院居民中便秘症状的流行率从 2007 年的 36%上升到 2013 年的 40%。在控制年龄、性别、ADL、认知障碍以及阿片类药物和抗胆碱能药物的使用后，这一差异具有统计学意义。在控制人口统计学变化的情况下，2007 年和 2013 年之间定期使用泻药的差异具有统计学意义，分别为 46%和 59%。开处阿片类药物和抗胆碱能药物的人群便秘风险增加，而 ADL 评分较高的人群便秘风险降低。此外，在开处阿片类药物和被评为便秘的人群中，2007 年有 35%和 2013 年有 20%的人未被开处常规使用的泻药，这一差异具有统计学意义。
结论
2007 年至 2013 年间，便秘症状的流行率有所增加。尽管这两年之间有所下降，但仍有许多开处阿片类药物且被评为便秘的人没有接受泻药治疗。因此，本研究表明，便秘仍然是养老院居民的一个严重问题，同时也表明，开处阿片类药物的人群如果需要，可能会受益于对便秘风险和治疗的认识提高。
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