卡塔尔初级保健中心就诊老年患者的多药治疗流行情况及其与非传染性疾病的相关性：一项横断面研究。
Prevalence of polypharmacy and the association with non-communicable diseases in Qatari elderly patients attending primary healthcare centers: A cross-sectional study.
机构信息
Community Medicine Residency Program, Hamad Medical Corporation, Doha, Qatar.
Community Medicine Residency Program, Primary Health Care Corporation, Doha, Qatar.
出版信息
PLoS One. 2020 Jun 11;15(6):e0234386. doi: 10.1371/journal.pone.0234386. eCollection 2020.
BACKGROUND
Polypharmacy has become a global public health concern particularly in the elderly population. The elderly population is the most susceptible to the negative effects of polypharmacy due to their altered pharmacokinetics and decreased drug clearance. Therefore, polypharmacy can lead to poor health status and higher rates of morbidity and mortality.
OBJECTIVE
The objective of this study was to determine the prevalence of polypharmacy (≥ 5 drugs) and its association with non-communicable diseases (NCDs) in elderly (≥65 years) Qatari patients attending Primary Healthcare (PHC) centers in Qatar.
METHODS
A retrospective cross-sectional analysis was conducted using the Electronic Medical Record (EMR) database of all PHC centers in Qatar for six months (April-September 2017).
RESULTS
Out of 5639 patients screened, 75.5% (95% CI: 74.3-76.6) were exposed to polypharmacy. Females were 1.18 times more likely to have polypharmacy compared to males (95% CI: 1.03-1.34). The multivariate analysis identified having hypertension (AOR 1.71; 95% CI: 1.38-2.13), diabetes (AOR 2.38; 95% CI: 1.97-2.87), dyslipidemia (AOR 1.29; 95% CI: 1.06-1.56), cardiovascular disease (AOR 1.56; 95% CI: 1.25-1.95) and asthma (AOR 1.39; 95% CI: 1.13-1.72) to be independent parameters associated with polypharmacy. Also, the Body Mass Index (BMI) and number of NCDs were found to be significant independent parameters associated with polypharmacy.
CONCLUSIONS
The prevalence of polypharmacy among Qatari elderly attending PHC Centers is very high. Our findings confirm the strong relationship between polypharmacy and BMI, and certain NCDs. Healthcare professionals should be educated about the magnitude of polypharmacy, its negative effects, and its associated factors. Best practice guidelines should be developed for improved medical practice in the prescription of medications for such a vulnerable population.
背景
药物滥用已成为一个全球性的公共卫生问题，尤其是在老年人群体中。由于老年人的药代动力学发生改变，药物清除率降低，他们最容易受到药物滥用的负面影响。因此，药物滥用会导致健康状况恶化，发病率和死亡率更高。
目的
本研究旨在确定在卡塔尔接受初级保健（PHC）中心治疗的老年（≥65 岁）卡塔尔患者中，药物滥用（≥5 种药物）的流行情况及其与非传染性疾病（NCD）的关系。
方法
使用卡塔尔所有 PHC 中心的电子病历（EMR）数据库，对 6 个月（2017 年 4 月至 9 月）的数据进行回顾性横断面分析。
结果
在筛选出的 5639 名患者中，有 75.5%（95%置信区间：74.3-76.6）暴露于药物滥用。与男性相比，女性发生药物滥用的可能性高 1.18 倍（95%置信区间：1.03-1.34）。多变量分析确定患有高血压（AOR 1.71；95%置信区间：1.38-2.13）、糖尿病（AOR 2.38；95%置信区间：1.97-2.87）、血脂异常（AOR 1.29；95%置信区间：1.06-1.56）、心血管疾病（AOR 1.56；95%置信区间：1.25-1.95）和哮喘（AOR 1.39；95%置信区间：1.13-1.72）是与药物滥用相关的独立参数。此外，体重指数（BMI）和 NCD 数量被发现与药物滥用有显著的独立关系。
结论
在卡塔尔接受 PHC 中心治疗的老年患者中，药物滥用的发生率非常高。我们的研究结果证实了药物滥用与 BMI 和某些 NCD 之间的密切关系。应教育医疗保健专业人员了解药物滥用的严重程度、其负面影响及其相关因素。应制定最佳实践指南，以改善对这类弱势群体的药物处方。
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