Pantuzza Laís Lessa Neiva, das Graças Braga Ceccato Maria, Reis Edna Afonso, Silveira Micheline Rosa, Almeida-Brasil Celline Cardoso, Almeida Thiago Augusto, Pinto Isabela Vaz Leite, Reis Adriano Max Moreira
Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia, Universidade Federal de Minas Gerais, 6627 Presidente Antônio Carlos Ave, Pampulha, Belo Horizonte, Minas Gerais, Brazil.
Faculdade de Farmácia, Universidade Federal de Minas Gerais, 6627 Presidente Antônio Carlos Ave, Pampulha, Belo Horizonte, Minas Gerais, Brazil.
Eur Geriatr Med. 2020 Apr;11(2):279-287. doi: 10.1007/s41999-019-00275-0. Epub 2019 Dec 5.
Complex medication regimens are common among older adults and contribute to the occurrence of undesirable health outcomes. This study aims to investigate the factors associated with high medication regimen complexity in older people.
A cross-sectional study was conducted with older adults selected from two primary healthcare units. Medication regimen complexity was measured using the Brazilian version of the Medication Regimen Complexity Index. The Pearson's Chi square test was used to analyse the individual association of each independent variable with high medication regimen complexity. The backward stepwise method was used to obtain the final multivariate logistic regression model.
We included 227 older adults with a median age of 70 years who were mostly females (70.9%). The median total Medication Regimen Complexity Index was 20.8 for high complexity and 10.5 for patients that were not using high complexity regimens. The Medication Regimen Complexity Index section with higher median scores in both groups was dosing frequency, followed by additional instructions. High complexity was associated with diabetes (OR 5.42; p = 0.00 2.69-10.93) and asthma/Chronic Obstructive Pulmonary Disease (OR 2.96(1.22-7.18); p = 0.02).
Older people in primary care with diabetes and respiratory disease were most likely to have complex medication regimens. Dosing frequency and additional instructions were medication regime complexity index components that most contributed to the high complexity in medication regime of older adults.
复杂的药物治疗方案在老年人中很常见，并会导致不良健康结果的发生。本研究旨在调查与老年人高药物治疗方案复杂性相关的因素。
对从两个基层医疗单位选取的老年人进行了一项横断面研究。使用巴西版药物治疗方案复杂性指数来衡量药物治疗方案的复杂性。采用Pearson卡方检验分析每个自变量与高药物治疗方案复杂性之间的个体关联。采用向后逐步法获得最终的多因素逻辑回归模型。
我们纳入了227名老年人，中位年龄为70岁，大多数为女性（70.9%）。高复杂性组的药物治疗方案复杂性指数中位数为20.8，非高复杂性方案组患者为10.5。两组中中位数得分较高的药物治疗方案复杂性指数部分是给药频率，其次是附加说明。高复杂性与糖尿病（比值比5.42；p = 0.00，2.69 - 10.93）和哮喘/慢性阻塞性肺疾病（比值比2.96(1.22 - 7.18)；p = 0.02）相关。
基层医疗中患有糖尿病和呼吸系统疾病的老年人最有可能有复杂的药物治疗方案。给药频率和附加说明是药物治疗方案复杂性指数的组成部分，对老年人药物治疗方案的高复杂性贡献最大。
