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分析门诊慢性病患者中不必要药物治疗的流行情况、风险因素和潜在费用。

Analysis of prevalence, risk factors, and potential costs of unnecessary drug therapy in patients with chronic diseases at the outpatient setting.

机构信息

Department of Pharmacy Practice, Yarmouk University, Irbid, Jordan.

Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2020 Feb;20(1):125-132. doi: 10.1080/14737167.2019.1612243. Epub 2019 May 13.

Abstract

: Patients with chronic diseases require long-term use of medications and are at risk for prescription of unnecessary drugs.: To determine the prevalence, risk factors, and costs associated with unnecessary drugs in patients with chronic diseases at outpatient settings.: Clinical and demographic data, unnecessary drug therapy and prices of drugs were obtained from 2,677 patients from the outpatient setting of six major hospitals in Jordan. Multivariate logistic regression was used to determine risk factors associated with unnecessary drug therapy.: A total of 936 unncessary medications were identified with an average of one unnecessary medication per every three patients. Monthly costs of unnecessary medications, at the national level, were estimated to range between JD 438,930.24 [(618,821.41 USD) (payer's perspective)] and JD 744,765.5 [(1,050,000.19 USD) (patient's perspective)]. Unnecessary drug was associated with cardiac catheterization (adjusted odds ratio [AOR] = 1.29, 95% CI: 1.01-1.71, = 0.041), increased number of medications (AOR = 3.11, 95% CI: 2.51-3.86, < 0.001), and inadequate knowledge/understanding of drug use (AOR = 2.4, 95% CI: 1.24-4.64, = 0.009).: Unnecessary drug therapy is common in the outpatient setting. Identified risk factors should be specifically targeted to reduce its burden.

摘要

患者患有慢性病,需要长期使用药物,存在开具不必要药物的风险。

目的

确定门诊环境中慢性病患者开具不必要药物的流行率、风险因素和成本。

方法

从约旦六家主要医院的门诊环境中,获取了 2677 名患者的临床和人口统计学数据、不必要药物治疗和药物价格。使用多变量逻辑回归来确定与不必要药物治疗相关的风险因素。

结果

共确定了 936 种不必要的药物,平均每三名患者就有一种不必要的药物。从国家层面来看,不必要药物的月费用估计在 438930.24 约旦第纳尔(618821.41 美元)(付款人视角)到 744765.5 约旦第纳尔(1050000.19 美元)(患者视角)之间。不必要的药物与心脏导管检查(调整后的优势比 [AOR] = 1.29,95%置信区间:1.01-1.71, = 0.041)、药物数量增加(AOR = 3.11,95%置信区间:2.51-3.86, < 0.001)和对药物使用的了解/认识不足(AOR = 2.4,95%置信区间:1.24-4.64, = 0.009)有关。

结论

不必要的药物治疗在门诊环境中很常见。应特别针对确定的风险因素,以减轻其负担。

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