Pulkki Jutta, Aaltonen Mari, Raitanen Jani, Rissanen Pekka, Jylhä Marja, Forma Leena
Faculty of Social Sciences, Tampere University, Tampere, Finland.
Eur J Ageing. 2019 Nov 14;17(3):361-369. doi: 10.1007/s10433-019-00543-9. eCollection 2020 Sep.
While it is known that those who are living their last years are frequent users of social and health services, research about medicines at the end of life is scarce. We examined whether the proportions of purchasers and the types of prescription medicines purchased during a 2-year period differed between community-dwelling old people who died (decedents) in 2002, 2006 or 2011 and old people who lived at least 2 years longer (survivors) in Finland. We also examined how those differences changed over time. The study population was identified from nationwide registers and consisted of 174,097 community-dwelling people who were 70 years of age or older. Of these, 81,893 were decedents and 92,204 survivors. Data on purchases of medicines were gathered from the Finnish prescription database. Along with descriptive analyses, binary logistic regression analysis was used to find the association between decedent status and the purchase of medicines in general and different categories of medicines in particular. Almost all community-dwelling decedents and survivors purchased medicines at least once during the 2-year period. Over time, the proportion of purchasers increased in both groups but especially among survivors, thereby reducing the differences between the groups. However, the probability of purchasing medicines in general and different categories of medicine in particular remained significantly higher for decedents than for survivors after adjustments. This study shows that purchases of medication are concentrated at the end of life, as is the use of social and health services. However, the differences between decedents and survivors diminish over time.
虽然已知那些处于生命最后几年的人经常使用社会和医疗服务，但关于临终时用药的研究却很匮乏。我们研究了在芬兰，2002年、2006年或2011年去世的（已故）社区居住老年人与至少多活了2年的（存活者）老年人在2年期间购买者的比例以及所购买处方药的类型是否存在差异。我们还研究了这些差异如何随时间变化。研究人群从全国登记册中确定，由174,097名70岁及以上的社区居住者组成。其中，81,893人为已故者，92,204人为存活者。药品购买数据从芬兰处方药数据库收集。除了描述性分析外，还使用二元逻辑回归分析来找出已故状态与一般药品购买以及特定类别药品购买之间的关联。几乎所有社区居住的已故者和存活者在2年期间至少购买过一次药品。随着时间的推移，两组中购买者的比例都有所增加，但存活者中增加得尤为明显，从而缩小了两组之间的差异。然而，经过调整后，已故者购买一般药品和特定类别药品的可能性仍然显著高于存活者。这项研究表明，药物购买集中在生命末期，社会和医疗服务的使用也是如此。然而，已故者和存活者之间的差异会随着时间的推移而减小。
