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伴有闭角型青光眼患者的潜在不合理抗胆碱能药物处方。

Potentially inappropriate prescriptions of anticholinergic medications in patients with closed-angle glaucoma.

机构信息

Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Calle 105 No. 14-140, Pereira, Risaralda, 660003, Colombia.

Biomedicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia.

出版信息

Int Ophthalmol. 2020 Apr;40(4):803-809. doi: 10.1007/s10792-019-01241-2. Epub 2019 Dec 3.

Abstract

PURPOSE

Glaucoma is the leading cause for blindness after cataracts worldwide. The aim was to identify anticholinergic drugs prescribed to patients diagnosed with closed-angle glaucoma in Colombia.

METHODS

This cross-sectional study identified the prescribing patterns of cholinergic antagonists related to the increased intraocular pressure in patients diagnosed with closed-angle glaucoma from a Colombian database. The Anticholinergic Drug Scale was used to quantify the anticholinergic burden.

RESULTS

We identified 1958 patients with closed-angle glaucoma, with a mean age of 70.5 ± 10.3 years, 72.9% of whom were women. Cholinergic antagonists were prescribed in at least 32.4% of cases. An age range between 75 and 84 years (odds ratio (OR) 2.35, 95% confidence interval (CI) 1.366-4.059) and being aged 85 years or older (OR 3.40, 95% CI 1.809-6.425) were associated with a greater probability of receiving an anticholinergic burden between 1 and 2 points. Females (OR 1.54, 95% CI 1.096-2.181) had a higher probability of receiving an anticholinergic burden ≥ 3 points. Interactions between antiglaucoma medications and anticholinergic treatments were identified in 32.1% of the patients.

CONCLUSIONS

Most patients were prescribed multiple antiglaucoma medications, reflecting a large number of potentially inappropriate prescriptions, with anticholinergic drugs, related to the increased intraocular pressure.

摘要

目的

青光眼是全球继白内障之后导致失明的首要原因。本研究旨在确定在哥伦比亚被诊断为闭角型青光眼的患者中开具的抗胆碱能药物。

方法

本横断面研究从哥伦比亚数据库中确定了与闭角型青光眼患者眼内压升高相关的拟交感神经拮抗剂的开方模式。使用抗胆碱能药物量表来量化抗胆碱能负担。

结果

我们确定了 1958 例闭角型青光眼患者,平均年龄为 70.5±10.3 岁,其中 72.9%为女性。至少有 32.4%的患者开具了拟交感神经拮抗剂。年龄在 75-84 岁之间(比值比 (OR) 2.35,95%置信区间 (CI) 1.366-4.059)和 85 岁或以上(OR 3.40,95% CI 1.809-6.425)与接受 1-2 分抗胆碱能负担的可能性更大相关。女性(OR 1.54,95% CI 1.096-2.181)接受抗胆碱能负担≥3 分的可能性更高。在 32.1%的患者中发现了抗青光眼药物和抗胆碱能治疗之间的相互作用。

结论

大多数患者开具了多种抗青光眼药物,反映出大量潜在不适当的处方,包括与眼内压升高相关的抗胆碱能药物。

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