Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnologica de Pereira-Audifarma S.A, Pereira, Colombia.
Grupo de Biomedicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia.
Dig Dis. 2020;38(6):500-506. doi: 10.1159/000506981. Epub 2020 Mar 6.
Constipation is a very common functional gastrointestinal disorder in the general population and can be primary or secondary.
The aim of this study was to estimate the anticholinergic burden of prescribed drugs in a population diagnosed with constipation in Colombia.
This was a cross-sectional study that used a population database of 6.5 million people to identify the prescription of cholinergic antagonists and drugs for the management of constipation in outpatient services. The anticholinergic burden was evaluated using the Anticholinergic Drug Scale. Potentially inappropriate prescriptions that increased the risk of constipation were identified.
A total of 3,887 patients with constipation were identified; the identified patients had a mean age of 54.4 ± 21.9 years, and 69.4% were women. Eighty percent received at least one laxative, and the most prescribed laxative was bisacodyl (50.5%). Forty-one percent (n = 1,586) of all patients received drugs with cholinergic antagonist activity, in particular codeine (6.5%) and valproic acid (6.5%). Being over 30 years of age (odds ratio [OR]: 1.79; 95% confidence interval [CI]: 1.24-2.57), being treated in the cities of Manizales (OR: 2.20; 95% CI: 1.50-3.21) and Pereira (OR: 1.49; 95% CI: 1.07-2.09), and having hypothyroidism as a comorbidity (OR: 1.37; 95% CI: 1.08-1.73) were associated with a greater probability of receiving medications with an anticholinergic burden of 3 or more points.
The majority of patients with constipation were women and were using laxatives to manage constipation. A large proportion of patients were prescribed at least one cholinergic antagonist drug, with an increased probability of use after 30 years of age.
便秘是普通人群中一种非常常见的功能性胃肠道疾病，可分为原发性或继发性。
本研究旨在评估在哥伦比亚被诊断为便秘的人群中，处方药物的抗胆碱能负担。
这是一项横断面研究，使用 650 万人的人群数据库来识别在门诊服务中开具的胆碱能拮抗剂和便秘治疗药物。使用抗胆碱能药物量表评估抗胆碱能负担。确定增加便秘风险的潜在不适当处方。
共确定了 3887 例便秘患者；这些患者的平均年龄为 54.4±21.9 岁，69.4%为女性。80%的患者至少接受了一种泻药，最常开的泻药是比沙可啶（50.5%）。41%（n=1586）的所有患者接受了具有胆碱能拮抗剂活性的药物，特别是可待因（6.5%）和丙戊酸（6.5%）。年龄超过 30 岁（比值比[OR]：1.79；95%置信区间[CI]：1.24-2.57）、在马尼萨莱斯（OR：2.20；95%CI：1.50-3.21）和佩雷拉（OR：1.49；95%CI：1.07-2.09）接受治疗以及患有甲状腺功能减退症作为合并症（OR：1.37；95%CI：1.08-1.73）与接受抗胆碱能负担 3 分或以上药物的可能性更大相关。
大多数便秘患者为女性，并用泻药来治疗便秘。很大一部分患者至少开了一种胆碱能拮抗剂药物，30 岁以后使用的可能性增加。
