Assari Shervin, Helmi Hamid, Bazargan Mohsen
Department of Family Medicine, Charles R. Drew University of Medicine and Sciences, Los Angeles, CA 90095, USA.
Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA.
Pharmacy (Basel). 2019 Mar 29;7(2):33. doi: 10.3390/pharmacy7020033.
Despite the association between polypharmacy and undesired health outcomes being well established, very little is known about epidemiology of polypharmacy in the African American community. We are not aware of any nationally representative studies that have described the socioeconomic, behavioral, and health determinants of polypharmacy among African Americans. We aimed to investigate the socioeconomic and health correlates of polypharmacy in a national sample of African American adults in the US. The National Survey of American Life (NSAL, 2003⁻2004) included 3,570 African American adults. Gender, age, socioeconomic status (SES; education attainment, poverty index, and marital status), access to the healthcare system (health insurance and having a usual source of care), and health (self-rated health [SRH], chronic medical disease, and psychiatric disorders) in addition to polypharmacy (5 + medications) as well as hyper-polypharmacy (10 + medications) were measured. Logistic regressions were applied for statistical analysis. that About 9% and 1% of all African American adults had polypharmacy and hyper-polypharmacy, respectively. Overall, higher age, higher SES (education and poverty index), and worse health (poor SRH, more chronic medical disease, and psychiatric disorders) were associated with polypharmacy and hyper-polypharmacy. Individuals with insurance and those with a routine place for healthcare also had higher odds of polypharmacy and hyper-polypharmacy. Given the health risks associated with polypharmacy, there is a need for systemic evaluation of medication use in older African Americans with multiple chronic conditions. Such policies may prevent medication errors and harmful drug interactions, however, they require effective strategies that are tailored to African Americans.
尽管多重用药与不良健康结果之间的关联已得到充分证实，但对于非裔美国人社区多重用药的流行病学情况却知之甚少。我们并不知晓有任何全国代表性研究描述过非裔美国人多重用药的社会经济、行为和健康决定因素。我们旨在调查美国全国非裔美国成年人样本中多重用药的社会经济和健康关联因素。美国生活全国调查（NSAL，2003 - 2004年）纳入了3570名非裔美国成年人。除了多重用药（服用5种以上药物）和超多重用药（服用10种以上药物）外，还测量了性别、年龄、社会经济地位（SES；教育程度、贫困指数和婚姻状况）、获得医疗保健系统的机会（医疗保险和有常规医疗服务来源）以及健康状况（自我评定健康状况[SRH]、慢性疾病和精神障碍）。应用逻辑回归进行统计分析。所有非裔美国成年人中分别约有9%和1%患有多重用药和超多重用药。总体而言，年龄较大、社会经济地位较高（教育程度和贫困指数）以及健康状况较差（自我评定健康状况差、慢性疾病较多和精神障碍）与多重用药和超多重用药有关。有保险的人和有常规医疗保健场所的人患多重用药和超多重用药的几率也更高。鉴于多重用药相关的健康风险，有必要对患有多种慢性病的老年非裔美国人的用药情况进行系统评估。此类政策可能会预防用药错误和有害的药物相互作用，然而，它们需要针对非裔美国人量身定制的有效策略。
