Su B B, Ma J X, Song W, Yuan J, Dong X Y, Wan J
Gastroenterology Department of Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2020 Jul 7;100(25):1983-1987. doi: 10.3760/cma.j.cn112137-20200403-01066.
To investigate the characteristics of comorbidities and polypharmacy in middle-aged and elderly patients and assess the potential risk of drug-drug interactions. Retrospective analysis was carried out among the outpatients aged ≥45 years in the Second Medical Center of the PLA General Hospital from January to December 2016. The patient's comorbidities and polypharmacy were collected from the electronic medical records and annual physical examination reports. The frequency and grade of drug-drug interactions (DDIs) were summarized and ranked by Lexicomp(®) Drug Interactions database. A total of 1 340 patients were enrolled in the study, of which 930 patients (69.40%) used 5 or more drugs, and 660 patients (49.25%) used 10 or more drugs. Multivariate analysis showed that age and the number of comorbidities were independent factors of excessive polypharmacy. The total frequency of detecting clinically significant DDIs (C+D+X) was 857 cases, with 0.8 cases per person by Lexicomp(®) Drug Interactions database. Among them, medications for nervous system accounted for the highest proportion of X-level DDIs. The comorbidities and polypharmacy in middle-aged and elderly patients are very prominent. More attention should be paid to drug interactions, especially in patients with neurological medication.
调查中老年患者合并症和多重用药的特征，并评估药物相互作用的潜在风险。对2016年1月至12月解放军总医院第二医学中心年龄≥45岁的门诊患者进行回顾性分析。从电子病历和年度体检报告中收集患者的合并症和多重用药情况。通过Lexicomp(®)药物相互作用数据库汇总并排列药物相互作用（DDIs）的频率和等级。本研究共纳入1340例患者，其中930例（69.40%）使用5种或更多药物，660例（49.25%）使用10种或更多药物。多因素分析显示，年龄和合并症数量是多重用药过多的独立因素。通过Lexicomp(®)药物相互作用数据库检测到具有临床意义的DDIs（C+D+X）的总频率为857例，人均0.8例。其中，神经系统用药在X级DDIs中占比最高。中老年患者的合并症和多重用药情况非常突出。应更加关注药物相互作用，尤其是使用神经科药物的患者。
