Annaheim Beatrice, Wangmo Tenzin, Bretschneider Wiebke, Handtke Violet, Elger Bernice S, Belardi Angelo, Meyer Andrea H, Hösli Raphael, Lutters Monika
Institute for Biomedical Ethics, University of Basel , Basel, Switzerland.
Division of Clinical Psychology and Epidemiology, Faculty of Psychology, University of Basel , Basel, Switzerland.
Int J Prison Health. 2019 Aug 29;15(3):250-261. doi: 10.1108/IJPH-07-2018-0040. Epub 2019 Mar 15.
The purpose of this paper is to determine the prevalence of polypharmacy and drug-drug interactions (DDIs) in older and younger prisoners, and compared if age group is associated with risks of polypharmacy and DDIs.
DESIGN/METHODOLOGY/APPROACH: For 380 prisoners from Switzerland (190 were 49 years and younger; 190 were 50 years and older), data concerning their medication use were gathered. MediQ identified if interactions of two or more substances could lead to potentially adverse DDI. Data were analysed using descriptive statistics and generalised linear mixed models.
On average, older prisoners took 3.8 medications, while younger prisoners took 2.1 medications. Number of medications taken on one reference day was higher by a factor of 2.4 for older prisoners when compared to younger prisoners ( = 0.002). The odds of polypharmacy was significantly higher for older than for younger prisoners (>=5 medications: odds ratio = 5.52, = 0.035). Age group analysis indicated that for potentially adverse DDI there was no significant difference (odds ratio = 0.94; = 0.879). However, when controlling for the number of medication, the risk of adverse DDI was higher in younger than older prisoners, but the result was not significant.
ORIGINALITY/VALUE: Older prisoners are at a higher risk of polypharmacy but their risk for potentially adverse DDI is not significantly different from that of younger prisoners. Special clinical attention must be given to older prisoners who are at risk for polypharmacy. Careful medication management is also important for younger prisoners who are at risk of very complex drug therapies.
本文旨在确定老年和青年囚犯中多重用药及药物相互作用（DDIs）的发生率，并比较年龄组是否与多重用药及药物相互作用的风险相关。
设计/方法/途径：收集了来自瑞士的380名囚犯（190名年龄在49岁及以下；190名年龄在50岁及以上）的用药数据。MediQ确定了两种或更多物质的相互作用是否会导致潜在的不良药物相互作用。使用描述性统计和广义线性混合模型对数据进行分析。
老年囚犯平均服用3.8种药物，而青年囚犯平均服用2.1种药物。与青年囚犯相比，老年囚犯在一个参考日服用的药物数量高出2.4倍（P = 0.002）。老年囚犯多重用药的几率显著高于青年囚犯（≥5种药物：优势比 = 5.52，P = 0.035）。年龄组分析表明，对于潜在的不良药物相互作用，没有显著差异（优势比 = 0.94；P = 0.879）。然而，在控制用药数量后，青年囚犯发生不良药物相互作用的风险高于老年囚犯，但结果不显著。
原创性/价值：老年囚犯多重用药的风险较高，但他们发生潜在不良药物相互作用的风险与青年囚犯没有显著差异。必须对有多重用药风险的老年囚犯给予特别的临床关注。对于有非常复杂药物治疗风险的青年囚犯，谨慎的药物管理也很重要。
